The first 24 hours after surgery: how an anesthetist, a surgeon and a nurse would like to be treated if they were patients

proceedings Over the last 20 years improvements in surgical and anesthesiologi-cal techniques have reduced mortality, morbidity and the length of hospital stay. Despite these considerable efforts, a great number of patients still develop perioperative complications. The ERAS (Enhanced Recovery After Surgery) concept aims to apply an evidence-based, standardized perioperative care protocol instead of traditional management based on habits (1). The philosophy behind the protocol can be summarized in two crucial points: 1. the knowledge of factors that can lead to complications in surgical patients; 2. the application of a specific strategy during the perioperative period aimed at patient well being with swift recovery after surgical stress. In order to put this idea into practice a team of healthcare professionals is required, made up not only of surgeons, anesthesiologists and nurses, but also of physiotherapists, nutritionists and administrative staff. The program is developed during those phases where the patient is involved, namely the pre-operative, intra-operative and post-operative periods: 1) pre-operative: evaluation of the patient's physical, nutritional and mental status, with patient participation through counseling with the surgeon, anesthetist and nurse; 2) intra-operative: mini-invasive surgery, anesthesia with short acting drugs avoiding fluids overload and, if possible, regional anesthesia ; 3) post-operative: pain control, early nutrition and mobilization.