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Med Intensiva (Engl Ed) ; 44(1): 46-53, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31174894

RESUMO

Patient care after major head and neck surgery has changed in recent years. Tumors are the most common reasons for this type of surgery, though it is also used to treat benign conditions. Recent advances in equipment and surgical techniques have improved the postoperative course in this field, allowing early recovery, less pain and infection, a shorter hospital stay, and even better aesthetic results. This is due to the use of minimally invasive techniques, which are gaining relevance. Such techniques allow complex procedures in the head and neck region, through natural orifices or small incisions, with minimal damage and sequelae for the patients. Despite these advances, however, the complexity of the treatment intervention requires multidisciplinary patient management, mostly in the Intensive Care Unit, in order to monitor the possible occurrence of complications. Potential risk factors include previous comorbidity, the type of surgery involved (e.g., bilateral cervical lymphadenectomy), multiple transfusions, and the appearance of early complications requiring repeat surgery. Despite the existence of several studies, there are no standardized protocols for the postoperative period in surgeries of this kind. This causes many specialists to resort to accelerated recovery protocols (ERAS: "Enhanced Recovery After Surgery") that have already been established in other surgical specialties.


Assuntos
Cuidados Críticos/métodos , Unidades de Terapia Intensiva , Procedimentos Cirúrgicos Bucais , Procedimentos Cirúrgicos Otorrinolaringológicos , Cuidados Pós-Operatórios/métodos , Manuseio das Vias Aéreas/métodos , Analgesia , Circulação Sanguínea , Humanos , Hipnóticos e Sedativos/uso terapêutico , Tempo de Internação , Insuficiência de Múltiplos Órgãos/terapia , Dor Pós-Operatória/terapia , Admissão do Paciente , Complicações Pós-Operatórias/terapia , Hemorragia Pós-Operatória/terapia , Procedimentos Cirúrgicos Robóticos , Transplante de Pele , Trombose/terapia , Fatores de Tempo
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