|Interview to Prof. Kehlet|
“It is well established that fast-track surgery requires less nursing care and really they do not need special training but just to be informed to follow the specified procedure-specific evidence-based care programmes”.
1. Which one was the start point of all we now know as enhanced recovery surgery?
The initiative on enhanced recovery surgery was the question "why is all surgeries on an outpatient basis and why do we need to have the risk of medical morbidity
2. According to you, what should be the main objective of any Enhanced recovery program?
The main objective of fast-track surgery is to have a pain and risk-free operation.
3. By the way, enhanced recovery or fast-track what is the most appropriate name for these protocols?
To be honest, I do not care about the name, but I still think that fast-track surgery is the most easy one.
4. Are all patients candidates for Fast Track?
Yes, all patients are candidates for fast-track.
5. Among the different steps that usually forms the enhanced recovery programs, which one do you think is the most important?
It is important to realise that nobody can answer which step is most important, except that a preoperative evidence-based care plan is of uttermost importance.
6. On average how much faster would a patient who has had fast track surgery be up and walking, compared to one who’s had traditional surgery?
How much earlier patients can be mobilised and walking, etc has been published repeatedly in the literature and they can be up even a few hours after major surgery
7. Do Enhance Recovery Programme patients require more nursing care and do nurses need special training in Enhanced Recovery?
It is well established that fast-track surgery requires less nursing care and really they do not need special training but just to be informed to follow the specified procedure-specific evidence-based care programmes.
8. Is it is assumed that Fast Track programmes are a number of evidenced–based interventions to improve both care and recovery. Why they are so difficult to be worldwide accepted?
The reason for the slow implementation is too many traditions in the hospital system.
9. Which would be your recommendations to any who wants to start with a Fast Track Surgery programme?
For those who wants to start with a fast-track surgery programme, I recommend reading the literature and then try (see guidelines, Kehlet & Wilmore, Ann Surg 2008...)