Postoperative orthostatic intolerance: a common perioperative problem with few available solutions

Excerpt

Over the past decade or so, several procedure-specific Enhanced Recovery After Surgery (ERAS) programs have been documented to have beneficial effects, including reduced length of stay (and fewer medical complications) without increasing hospital readmission rates. Early mobilization has been a key element in the multimodal concept of fast-track surgery and ERAS programs, with subsequent positive effects on pulmonary and thromboembolic complications and avoidance of loss of muscle function through immobility. Although postoperative orthostatic intolerance (OI), characterized by symptoms of dizziness, nausea, vomiting, blurred vision, or syncope during sitting or standing,1 is a well-known clinical problem that can delay early mobilization, relatively few data are available on its mechanism and possible treatment. Consequently, the aim of this freestanding editorial is to provide an update and perspective on the current knowledge regarding the pathogenesis and mechanisms of OI and potential future treatment strategies. …