Multimodal Prehabilitation

There is growing evidence for the use of prehabilitation before major surgery to maximize patients’ nutrition, physical condition and cardiovascular fitness, respiratory status and psychological well-being. This is particularly important in cancer surgery. Patients commonly report reduced functional capacity, pain, fatigue, reduced sleep and appetite long after discharge.

There is a window, albeit narrow, before surgery to implement the supervised exercise and nutritional optimization discussed in this article in Anaesthesia, especially in at risk patients – frail, elderly or cancer patients. Concurrently, optimization of respiratory function, anemia correction, smoking cessation, diabetes and cardiac status should occur.

The logistics and economic ramifications will clearly need to be addressed.

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