IMPACT OF ANESTHETIC PREHABILITATION ON THE RECOVERY OF PATIENTS UNDERGOING MAJOR SURGERY: A SYSTEMATIC REVIEW

Abstract

This systematic review evaluated the impact of anesthetic prehabilitation on postoperative recovery in patients undergoing major surgery, highlighting the importance of interventions aimed at optimizing both the physical and psychological aspects of patients before the procedure. We included 20 studies that investigated various perioperative strategies, covering specific interventions – such as coronary revascularization, biliary drainage, administration of gabapentin, alpha-1 blockers, and gabapentinoids – as well as integrated rehabilitation programs. The analysis considered outcomes related to the incidence of complications, length of hospital stay, morbidity, quality of life, and hospital readmission, in addition to examining the efficacy of complementary measures, such as the use of melatonin and the application of advanced techniques, such as preoperative embolization and preoperative magnetic resonance imaging. The results showed that, although several interventions have the potential to improve clinical outcomes – showing, for example, a reduction in acute myocardial infarction in the long term, a decrease in opioid consumption, and an improvement in lung function – the effects vary considerably according to the type of procedure and the patient's profile. The heterogeneity of the studies and the predominance of low- to moderate-certainty evidence reinforce the need for caution in generalizing the findings, pointing to the importance of individualized approaches and standardization of protocols. In conclusion, the integration of specific measures with multidisciplinary approaches shows promise for improving perioperative outcomes, contributing to the reduction of complications and acceleration of postoperative recovery. However, new clinical trials with methodological rigor are essential to consolidate these findings and improve anesthetic management strategies, to offer safer and more effective care to patients undergoing major surgery.