Fast Track (Acerto) in Elderly Patients for Hip Orthopedic Surgeries. Ten Years of Experience

Abstract

In 2010, we started implementing the ACERTO project in a hospital in the northeast of the Brazilian Public Health (SUS) after five weeks with all stakeholders involved in the departments of Anesthesiology, Orthopedics, Geriatrics, Nutrition, Nursing, Physiotherapy, Psychology and Social Service. In the same way as in other hospitals, the implementation of fast track surgery was not obtained by all departments and all health professionals. The use of ACERTO protocol with clinical measures of accelerating patient recovery decreased length of stay, the number of suspensions of surgery, the need for ICU, the use of vesical catheter, the time of fasting, the time of oral food reintroduction, high earlier and faster return to family life, working as humanization of treatment to the elderly. Analgesia in all patients was obtained with local anesthetics through different plexus blocks with neurostimulator and no patient used spinal opioids. In medicine the vast majority is terribly attached to their arguments and no one is willing to give in to new truths. Dreaming costs nothing and the implementation of the ACERTO Project will cost nothing to any institution.