Copyright
©The Author(s) 2020.
World J Gastroenterol. Jun 21, 2020; 26(23): 3271-3282
Published online Jun 21, 2020. doi: 10.3748/wjg.v26.i23.3271
Published online Jun 21, 2020. doi: 10.3748/wjg.v26.i23.3271
Serial number | Measures | Treatment group (fast track surgery) | Control group |
Preoperation | |||
1 | Mission | Explaining the process of rapid rehabilitation surgery to relieve patient tension: (1) Communicating with the patient prior to the operation to reduce the fear of the unfamiliar environment; (2) Explaining the preparation and cooperation prior to and after the operation, how to get out of bed for exercising as soon as possible after operation, and how to restore early drinking and eating; (3) Informing the patient regarding the time of discharge from the hospital after the operation; and (4) Performing all necessary psychological nursing to relieve anxiety in the patients prior to operation | Appropriate care for the psychological problems of the patients, health management for the disease, and adequate sleep |
2 | Fasting, water prohibition | Fasting 6 h, water prohibition 4 h | Overnight water prohibition and fasting prior to the operation |
3 | Basic disease control and support therapy | Routine treatment | Routine treatment |
4 | Intestinal preparation | Cleansing of intestines at 18:00 one night prior to the operation | Cleansing of intestines at 18:00 one night prior to the operation at night |
Intraoperation | |||
5 | Anesthesia | General anesthesia for endotracheal intubation | General anesthesia for endotracheal intubation |
6 | Intraoperative heat preservation | Stabilization of the heat (i.e., use of a heated quilt to maintain the body temperature and warm distilled water to wash the wound) | Normal temperature treatment in the operation room |
7 | Drainage tube | Unconventional placement | Conventional placement |
8 | Gastric tube | Unconventional placement | Conventional placement |
Postoperation | |||
9 | Restrictive rehydration | Limiting the amount of infusion, especially the intake of salt, in principle not parenteral nutrition | Conventional rehydration |
10 | Analgesia | Intravenous analgesia and avoidance of morphine and opioid drugs. Reference scheme: PCIA scheme 1: sulfentanyl 50–80 μg + kyffin 200 mg, initial dose: sulfentanyl 5 μg + kyffin 50 mg; PCIA scheme 2: sulfentanyl 50 μg + dezocine 30–40 mg, initial dose: sulfentanyl 5 μg + dezocine 5 mg | Intravenous analgesia and avoidance of morphine and opioid drugs. Reference scheme: PCIA scheme 1: sulfentanyl 50–80 μg + kyffin 200 mg, initial dose: sulfentanyl 5 μg + kyffin 50 mg; PCIA scheme 2: sulfentanyl 50 μg + dezocine 30–40 mg, initial dose: sulfentanyl 5 μg + dezocine 5 mg |
11 | Early feeding | Early enteral nutrition, initiation of liquid diet on the first day after the operation, if no discomfort; gradual recovery of semi flow diet and general diet | A full-flow diet after the anal exhaust; recovery of half-flow diet after defecation; restoration of general diet 7 d after the operation |
12 | Early activity | Initiation of activities on the first day after the operation | Gradual initiation of activities based on the patient’s will and recovery |
13 | Catheter | Removal of catheter on the first day after the operation, in the absence of prostatic hyperplasia or another urinary tract obstruction | Catheter was removed in the second day after the operation if it is not prostatic presence of hyperplasia or another urinary tract obstruction |
14 | Drainage tube | Removal of the tube if the drainage is < 50 mL | Regular placement for 5 to 7 d |
15 | Gastric tube | Removal on the second day after the operation | Routine placement until exhaust and defecation |
16 | Antibiotic | Use according to the principles for the clinical application of antimicrobial agents established by the Ministry of Health | Use according to the principles for the clinical application of antimicrobial agents established by the Ministry of Health |
17 | Medication | Conventional treatment + Yikou-Sizi powder hot compress. No use of gastrointestinal motility medicine, Chinese medicine decoction, or Chinese patent medicine. No enema treatment performed within 3 d after operation. No use of parenteral nutrition in principle | Conventional treatment, No use of gastrointestinal motility medicine, Chinese medicine decoction, or Chinese patent medicine. No enema treatment performed within 3 d after operation. No use of parenteral nutrition in principle |
- Citation: Cao LX, Chen ZQ, Jiang Z, Chen QC, Fan XH, Xia SJ, Lin JX, Gan HC, Wang T, Huang YX. Rapid rehabilitation technique with integrated traditional Chinese and Western medicine promotes postoperative gastrointestinal function recovery. World J Gastroenterol 2020; 26(23): 3271-3282
- URL: https://www.wjgnet.com/1007-9327/full/v26/i23/3271.htm
- DOI: https://dx.doi.org/10.3748/wjg.v26.i23.3271