Page 172 - Hospital Authority Convention 2018

Masterclasses
HOSPITAL AUTHORITY CONVENTION 2018

M14.3 Evidence Based Perioperative Medicine 13:15 Theatre 2

Enhanced Recovery after Surgery in a Tertiary Cluster Hospital
Poon KS
Department of Anaesthesiology and Operating Theatre Services, Queen Elizabeth Hospital, Hong Kong
Enhanced Recovery After Surgery (ERAS) is a multimodal, multidisciplinary peri-operative care pathway designed to achieve
early recovery for patients undergoing major surgery. It was initially developed for colorectal surgery patients, but its
principles are now being applied to a wide range of surgical disciplines. The key elements of ERAS include optimisation of
nutrition, avoidance of prolonged peri-operative fasting, standardised analgesic and anaesthetic regimens, and early post-
operative mobilisation. These have been shown to reduce surgical stress response and end organ dysfunction, thereby
resulting in major improvements in clinical outcome.

Benefits of ERAS can be clinically translated into reduction in surgical complications and shorter hospital length of stay
without compromising patient safety. It has resulted in better health service utilisation as well as substantial improvement in
overall healthcare cost. This presentation aims to review the best evidence of ERAS from the literature, covering the concept
and its applications in general surgery.

M14.4 Evidence Based Perioperative Medicine 13:15 Theatre 2

Postoperative Troponitis – Can We Ignore a Rise in Cardiac Troponin after Surgery?
Chan M
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong

Postoperative myocardial injury represents a spectrum of etiologies that ranges from frank myocardial infarction to the more
Tuesday, 8 May 2018 mortality, it is unclear if “troponitis” also increases postoperative risks. The prevailing evidence would suggest that most
common, incrementally small, and isolated of postoperative troponin elevation. These small elevations, which exceed the
99th centile for a normal population, are commonly referred “troponitis”. While myocardial injury is associated with increased
physicians do not consider “troponitis” clinically important in that many of these patients lack an in-depth postoperative
evaluation, treatment or follow-up. The purpose of this presentation is to review the implications of troponitis after major
noncardiac surgery.

170