ABSTRACT
Current anesthetic and surgical practice allows us to modify and control many of the factors that continue to lead to physiological compromise, morbidity, and death following major surgery. Multimodal programs that address these factors have been reported for a variety of operations, and can lead to a more rapid recovery from surgery (and in some instances, earlier hospital discharge) (1). Rapid recovery is generally considered in the context of time to discharge from hospital, with length of stay used as a surrogate marker of fitness following surgery. The speed of recovery is not however the only consideration. Quality of recovery is also relevant and, particularly in the elderly and patients with significant comorbidities, improving the quality of recovery may not result in a dramatic reduction in hospital stay. Time to discharge is influenced by a multitude of other factors, including availability of carers and an appropriate care package, and the patient’s own desire to return home. What we are attempting to achieve with a rapid recovery program is perioperative care, which limits as far as possible an individual patient’s physiological compromise (due to surgery and anesthesia) and optimizes their recovery, allowing them to return to their normal level of function as quickly as possible. For many patients, this combination will make earlier discharge from hospital possible.
