Team-based approach to surgical stress reduction and procedural safety

This chapter focuses on the pathophysiology, management, and treatment of the surgical stress reaction. Surgical procedures result in various pathophysiological changes, such as alterations in hemodynamics, intense endocrine reactions, and changes in immune function. The extent of the stress response depends on several factors related to the surgery, anesthesia, and the patient (e.g., invasiveness and duration of surgery, anesthesia management, patient's functional status, multimorbidity, or frailty). All members of the surgical team are responsible for implementing measures aimed at reducing this complex metabolic reaction. Optimal preparation for surgery, including prehabilitation techniques, is crucial. The choice of the surgical approach can significantly impact this reaction by opting for minimally invasive techniques and reducing operative time. Anesthesia plays a crucial role in reducing surgical stress, primarily by blocking pain stimuli and eliminating consciousness. Nurses play a protective role throughout the surgical process, from their initial contact with the patient to hospital discharge. ERAS (Enhanced Recovery After Surgery) addresses factors influencing the surgical stress response. Procedural safety measures help prevent adverse events that could increase surgical stress.