Abstract
Fluid management is an essential component of the Enhanced Recovery after Surgery
(ERAS) pathway. Optimal management begins in the preoperative period and continues
through the intraoperative and postoperative phases. In this review, we outline current
evidence-based practices for fluid management through each phase of the perioperative
period. Preoperatively, patients should be encouraged to hydrate until 2 hours prior
to the induction of anesthesia with a carbohydrate-containing clear liquid. When mechanical
bowel preparation is necessary, with modern isoosmotic solutions, fluid repletion
is not necessary. Intraoperatively, fluid therapy should aim to maintain euvolemia
with an individualized approach. While some patients may benefit from goal-directed
fluid therapy, a restrictive, zero-balance approach to intraoperative fluid management
may be reasonable. Postoperatively, early initiation of oral intake and cessation
of intravenous therapy are recommended.
Keywords
Enhanced Recovery after Surgery - fluid management - goal-directed fluid therapy
