Fast-Track protocol:~Preoperative~Anesthetic consultation~Proposal of optimization of patient's general health state + family meeting if necessary~Hospitalization on day of surgery~Solids stopped 6 hours prior to surgery, drinking encouraged up to 2 hours prior to surgery~During surgery~Anti-infectious prophylaxis~Anesthesia via IV propofol/remifentanil~Anti-nausea prophylaxis~Pain control based on limited systemic opioid use~Postoperative~Balanced analgesia for pain control~Antithrombotic prophylaxis~Early oral refeeding~Rapid mobilization~Gum chewing~Foley catheter removal at the end of surgery~Peripheral IV catheter removal 6 hours postoperatively~Usual care protocol :~Preoperative~Anesthetic consultation~Hospitalization on day of surgery~Fasting beginning at midnight prior to surgery~During surgery~Anti-infectious prophylaxis~Balanced anesthesia via halogen gas~Anti-nausea medication if needed~Postoperative~Balanced analgesia for pain control~Antithrombotic prophylaxis~Same-day refeeding according to patient's wish~Same-day mobilization according to patient's wish~Foley and peripheral IV catheter removal on day 1 postoperatively
Objective: Evaluate the effects of a fast-track (FT) protocol on costs and postoperative recovery.~Design: randomized trial~Setting: University Hospitals~Population: 170 women undergoing total laparoscopic hysterectomy for a benign indication~Methods: A FT protocol included the combination of minimally invasive surgery, analgesia optimization, early oral refeeding and rapid mobilization of patients was compared to a usual care protocol.~Main outcomes measure: Primary outcome was costs. Secondary outcomes were length of stay, postoperative morbidity and patient satisfaction.