Optimal Pharmacotherapy Strategies for Enhanced Postoperative Recovery in High-Risk Surgeries

Strategies to optimize perioperative pharmacotherapy within an enhanced recovery paradigm rely on an assessment of the patient’s risk for operative stress and complications, a thorough medication history, and decisions to continue or withhold medications in preadmission and perioperative phases. In addition, providing prophylaxis for common postoperative complications, especially surgical site infection, venous thromboembolism, nausea and vomiting, pain, and delirium, can be achieved through preoperative reduction of tobacco and ethanol use, and assessment of nutritional status and anemia. Goal-directed fluid therapy throughout the perioperative period, according to certain guidelines, can minimize many cardiovascular, renal, and infectious morbidities. Opioid-sparing multimodal pain management strategies minimize opioid exposure without adverse impact on pain control or patient satisfaction. Preventive interventions and early recognition of complications is paramount to effective patient management and enhanced recovery.