«NONSURGICAL» ASPECTS OF SUCCESSFUL IMPLEMENTATION OF FAST TRACK PRINCIPLES INTO A SURGICAL CLINIC: OUR EXPERIENCE

Abstract

Introduction. The main postulate of Fast track surgery according to H. Kehlet is the reduction of negative moments in the postoperative period by reducing the intensity of the body’s stress response to surgery.The purpose of the work. Evaluate the effectiveness of the implementation of Fast track principles in the work of the surgical clinic.Materials and methods. In the period from September 2011 to January 2019, we performed 623 planned surgeries using the principles of Fast track surgery, including the use of multimodal analgesia (MMA) and nutritional support for patients.Results. In the control group on the subjective scale of VAS, patients rated the pain level at 6.26 ± 1.52 points, in the experimental group – at 2.74 ± 1.05 (P <0.001). The average length of stay in the hospital was 4.99 ± 0.45 and 4.10 ± 0.60 days, respectively. The indicator of general weakness in the control group was 6.47 ± 1.26 points, in the experimental group – 2.26 ± 0.86 (P <0.001). Depressive states in the first days after surgery are the result of the above complaints and feelings, in the control group, this figure averaged 4.79 ± 1.07 points, at the same time, in the experimental – 1.50 ± 0.86 (P <0.001).Conclusions. The use of the principles of Fast track surgery, namely multimodal analgesia in the perioperative period in combination with preoperative oral carbohydrate loading and early recovery of oral nutrition with adapted mixtures significantly affects the level of pain impulses in the first postoperative day.