Enhanced Recovery Pathways: the Direction in the Future

The introduction of enhanced recovery pathways has led to a considerable shift in the paradigm of perioperative care, which are now widely implemented in a variety of surgical specialties with large positive results. The principles of enhanced recovery are promoting recovery of normal functions, comprehensive perioperative interventions, multidisciplinary involvement and education, and evidence-based intervention. Enhanced recovery pathways were initially introduced in colorectal and cardiac surgery, and have been adopted amongst orthopedics, urology, obstetrics and gynecology, and other surgical specialties. Limitations for older or more frail patients, or patients undergoing emergent surgeries should be considered, and the pathways could be modified for those patients. In this review, we discussed the principles and status of enhanced recovery pathways as well as the room for further development.