将加速康复外科原则应用于非手术室麻醉环境：原理、当前证据和未来方向
Applying enhanced recovery after surgery principles to the nonoperating room anesthesia environment: rationale, current evidence, and future directions.
摘要(中文译文)
加速康复外科（ERAS）已发展成为众多外科领域围手术期管理中成熟且基于循证的框架。与此同时，微创及导管技术的进步大幅扩展了手术室外操作的数量和复杂性，导致非手术室麻醉（NORA）迅速增长。尽管ERAS原则与NORA患者需求之间存在明显重叠，但针对介入操作的综合性康复理念仍然有限。目前关于NORA中基于ERAS方法的证据稀少且异质性大，主要来源于消化内科、心血管内科和介入放射学。现有研究表明，部分加速康复原则在介入治疗中具有可行性，并可能改善患者舒适度、康复、安全性及操作效率。然而，实施往往较为碎片化，缺乏标准化的、基于路径的围介入期管理。加速康复原则在快速扩展的NORA环境中具有改善围介入期治疗的巨大潜力。关键缺口并非缺乏ERAS要素，而是缺乏与成熟外科ERAS路径相当的结构化围介入期康复治理。未来的进展需要整体性、多学科的康复框架，具有操作特异性调整的标准化理念，以及临床和经济学证据。鉴于麻醉学在围介入期连续管理中的核心作用，其有条件参与并可能引领手术室外结构化加速康复路径的发展。
Abstract
Enhanced recovery after surgery (ERAS) has evolved into a well established, evidence-based framework for perioperative care in numerous surgical disciplines. At the same time, advances in minimally invasive and catheter-based techniques have substantially expanded the number and complexity of procedures performed outside the operating room, leading to a rapid growth of nonoperating room anesthesia (NORA). Despite the clear overlap between ERAS principles and NORA patient needs, comprehensive recovery concepts for interventional procedures remain limited. Current evidence on ERAS-based approaches in NORA is sparse and heterogeneous, mainly originating from gastroenterology, cardiology, and interventional radiology. Existing studies suggest that selected enhanced recovery principles are feasible in interventional care and may improve patient comfort, recovery, safety, and procedural efficiency. However, implementation is often fragmented and lacks standardized, pathway-based peri-interventional management. Enhanced recovery principles hold substantial potential to improve peri-interventional care within the rapidly expanding NORA environment. The critical gap is not the absence of ERAS elements, but the absence of structured peri-interventional recovery governance comparable to established surgical ERAS pathways. Future progress will require holistic, multidisciplinary recovery frameworks, standardized concepts with procedure-specific adaptations, and clinical and economic evidence. Given its central role across the peri-interventional continuum, anesthesiology is well positioned to contribute to and potentially lead the development of structured enhanced recovery pathways beyond the operating room.
如何引用
AMA
Amanda Bischof, Richard D Urman, Markus M Luedi, Andrea Stieger. Applying enhanced recovery after surgery principles to the nonoperating room anesthesia environment: rationale, current evidence, and future directions.. Current opinion in anaesthesiology. 2026; doi:10.1097/ACO.0000000000001659.
APA
Amanda Bischof, Richard D Urman, Markus M Luedi, Andrea Stieger (2026). Applying enhanced recovery after surgery principles to the nonoperating room anesthesia environment: rationale, current evidence, and future directions.. Current opinion in anaesthesiology. https://doi.org/10.1097/ACO.0000000000001659
GB/T 7714
Amanda Bischof, Richard D Urman, Markus M Luedi, Andrea Stieger. Applying enhanced recovery after surgery principles to the nonoperating room anesthesia environment: rationale, current evidence, and future directions.[J]. Current opinion in anaesthesiology, 2026 doi:10.1097/ACO.0000000000001659.
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