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J Perioper Pract. 2018 Nov 12:1750458918812293. doi: 10.1177/1750458918812293. [Epub ahead of print]

Postoperative stress and pain response applying fast-track protocol in patients undergoing hepatectomy.

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1 Chief Nurse of PACU, Hellenic Anticancer Hospital "Saint Savvas", Day Care Surgery "N. KOURKOULOS" Hellenic Anticancer Institute, "Saint Savvas" Hospital, Athens, Greece.
2 Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece.
3 Hellenic Anticancer Institute, "Saint Savvas" Hospital, Athens, Greece.



To assess the clinical parameters and compare the stress and pain response between fast-track recovery protocol and conventional treatment in patients undergoing major liver resection.


Eighty-eight patients suffering from malignant liver tumours were surgically treated from May 2012 to March 2015. After randomisation, they were prospectively divided into two groups: group fast-track patients (nā€‰=ā€‰46) and group conventional treatment patients (nā€‰=ā€‰42). Demographic and clinical data were collected and patients were assessed with pain scale (behavioural observation scale and visual analog scale), while depression levels were evaluated with Zung self-rating depression scale and three Numeric Analog Scale self-reported questions. Peripheral blood samples were collected at time points: T1 on the admission day, T2 on the day of surgery and T3 on the day of discharge examining serum levels of adrenocorticotropic hormone and cortisol.


Fast-track recovery protocols seem to be associated with improvement in several clinical parameters, without compromising, biologic or emotional stress in patients undergoing major liver resection.


Enhanced recovery program after liver resection; Fast-track after liver resection; Pain response; Stress response; Surgery trauma


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