Perioperative & Anesthesia Clinical Guidelines
Perioperative and anesthesia guideline index: the governing ASA, ERAS, ACC/AHA, ASRA, and Association of Anaesthetists guidelines, with edition and source.
Perioperative & Anesthesia
The perioperative and anesthesia hub. Indexes the governing ASA, ERAS, ACC/AHA, ASRA, and Association of Anaesthetists guidelines, each with a source link.
Perioperative medicine and anesthesiology is the discipline of caring for the patient before, during, and after a procedure: preoperative assessment and risk stratification, optimization of comorbid disease, the conduct of general, regional, and sedation anesthesia, airway management, intraoperative monitoring and hemodynamic support, blood management, pain control, prevention of postoperative nausea and vomiting, and structured recovery pathways that carry the patient from the operating room to discharge. It is inherently multidisciplinary, drawing on surgery, cardiology, nephrology, pharmacy, and nursing, and its guidance is published accordingly, by anesthesia societies, surgical societies, and cardiology societies working together.
This section is new. It currently indexes the governing professional-society guidelines for perioperative and anesthesia practice, each with a source link to the publisher, the journal landing page, or PubMed. Multi-part syntheses in the site’s usual format, integrating several societies’ recommendations into one reference with DOI-linked citations and sequential part pages, are being added and will be linked from this page as they publish.
Governing guidelines
| Guideline | Publisher | Edition | Scope | Source |
|---|---|---|---|---|
| Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration, with the 2023 modular update | American Society of Anesthesiologists | 2017; modular update 2023 | Fasting for healthy patients undergoing elective procedures; the 2023 module adds carbohydrate-containing clear liquids with or without protein, chewing gum, and pediatric fasting duration | PubMed |
| 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway | American Society of Anesthesiologists with international airway societies | 2022 (replaces 2013) | Evaluation of the airway, development of a difficult airway strategy, awake airway management, oxygenation throughout, and extubation of the difficult airway | PubMed |
| Fifth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting | American Society for Enhanced Recovery and Society for Ambulatory Anesthesia | 2025, fifth edition (supersedes 2020) | Identification of high-risk patients, reduction of baseline risk, prophylaxis, rescue treatment, and institutional PONV protocols, in adults and children | PubMed |
| Guidelines for Perioperative Care in Elective Colorectal Surgery: ERAS Society Recommendations 2025 | ERAS Society | 2025, fifth edition (replaces 2018) | Preoperative, intraoperative, and postoperative care elements for elective colorectal surgery, graded by GRADE | PubMed |
| Perioperative Care in Cardiac Surgery: A Joint Consensus Statement | ERAS Cardiac Society, ERAS Society, and The Society of Thoracic Surgeons | 2024 (updates 2019) | Enhanced recovery care elements for cardiac surgical procedures, including protective lung ventilation and ventilation on cardiopulmonary bypass | PubMed |
| 2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery | American College of Cardiology and American Heart Association | 2024 (supersedes 2014) | Perioperative cardiovascular evaluation and management of adults undergoing noncardiac surgery | Circulation |
| Association of Anaesthetists Guidelines: Safe Vascular Access 2025 | Association of Anaesthetists, with the Royal College of Anaesthetists, Intensive Care Society, NIVAS, and VASBI | 2025 | Vascular access teams and performance indicators, device selection, insertion including ultrasound and tip position, anticoagulation and catheter-related thrombosis, specific patient groups, and training | Association of Anaesthetists |
| Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy: ASRA Evidence-Based Guidelines | American Society of Regional Anesthesia and Pain Medicine | 2025, fifth edition (replaces 2018) | Neuraxial and peripheral regional anesthesia in patients receiving anticoagulant, antiplatelet, or thrombolytic drugs | PubMed |
| Standards for Basic Anesthetic Monitoring | American Society of Anesthesiologists | Approved 1986; last amended 2025 | Required monitoring of oxygenation, ventilation, circulation, and temperature during all anesthetics | ASA |
| Practice Guidelines for Central Venous Access 2020 | American Society of Anesthesiologists | 2020 (updates 2012) | Placement and management of central venous catheters, and reduction of infectious, mechanical, and thrombotic complications | PubMed |
| Practice Guidelines for Perioperative Blood Management | American Society of Anesthesiologists | 2015 (updates 2006) | Perioperative transfusion of blood and components, adjuvant therapies, techniques to reduce blood loss, and massive transfusion protocols | Anesthesiology |
| Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018 | American Society of Anesthesiologists with AAOMS, ACR, ADA, ASDA, and SIR | 2018 | Moderate sedation by any provider: patient evaluation, monitoring, sedative and analgesic agents, and recovery | PubMed |
How this section is used
For protocol development, start from the source list above. Each row links to the publisher’s page or the journal of record, where the full recommendation text, evidence grading, and any algorithm figures are available. Protocols on fasting, airway management, PONV prophylaxis, or neuraxial anesthesia in anticoagulated patients should cite the edition named in the table; several of these documents were replaced in 2025 and the older edition is still widely quoted.
For point-of-care questions, Lumen retrieves from this corpus and cites the page it drew from, so an answer about an ASA or ERAS recommendation can be traced back to the guideline that made it. Departments that run Lumen as a shared workspace can read how a perioperative service runs these guidelines as one shared Lumen workspace.
Related departments
- Vascular Access overlaps on central venous access, arterial lines, ultrasound-guided insertion, and the safe vascular access and central venous access guidelines indexed above.
- Critical Care overlaps on postoperative ICU admission, mechanical ventilation, sedation, and transfusion practice.
- Emergency Medicine overlaps on airway management, rapid sequence induction, and procedural sedation outside the operating room.
- Infection Prevention overlaps on surgical site infection prevention and aseptic technique for line placement.
- Oncology overlaps on anesthesia for cancer surgery and perioperative management of patients on chemotherapy or with cancer-associated thrombosis.
- Cardiology overlaps on perioperative cardiovascular evaluation, antithrombotic management, and patients with valvular or ischemic heart disease undergoing surgery.
- Nephrology & Dialysis overlaps on perioperative acute kidney injury and dialysis-dependent surgical patients.
- Surgery & Trauma overlaps on enhanced recovery pathways, surgical antimicrobial prophylaxis, and trauma anesthesia.
- Clinical Pharmacy overlaps on perioperative medication management, antithrombotic interruption, and antiemetic selection.
Frequently asked questions
What does the perioperative and anesthesia section of The Clinical Database cover?
The section indexes the professional-society guidelines that govern anesthesia and perioperative care: preoperative fasting, difficult airway management, postoperative nausea and vomiting, enhanced recovery pathways for colorectal and cardiac surgery, perioperative cardiovascular evaluation for noncardiac surgery, safe vascular access, regional anesthesia in patients on antithrombotic therapy, basic anesthetic monitoring, central venous access, perioperative blood management, and moderate procedural sedation. Each entry links to the publisher’s page, the journal landing page, or PubMed.
Which organizations publish the guidelines indexed here?
The American Society of Anesthesiologists (ASA) publishes practice guidelines and standards, several of them with international airway and specialty societies. The Society for Ambulatory Anesthesia and the American Society for Enhanced Recovery publish the PONV consensus guidelines. The ERAS Society, with the ERAS Cardiac Society and the Society of Thoracic Surgeons for cardiac surgery, publishes enhanced recovery pathway guidelines. The ACC/AHA publish the perioperative cardiovascular management guideline. The Association of Anaesthetists publishes the safe vascular access guidelines. ASRA publishes the antithrombotic guidelines for regional anesthesia.
Which PONV consensus guideline is current?
The Fifth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting, published as an executive summary in Anesthesia & Analgesia in November 2025, supersede the Fourth Consensus Guidelines of 2020. The table indexes the fifth edition.
Are multi-part guideline syntheses available for perioperative care yet?
Not yet. This section is new. The site’s usual format, a multi-society synthesis split into sequential part pages with DOI-linked citations, is being written for perioperative and anesthesia topics and will be linked from this page as each series publishes. Until then, the governing guidelines table is the reference.
Are these guidelines a substitute for institutional protocols?
No. They are published professional-society recommendations, indexed here to support clinicians and to inform institutional protocol development. Local protocols, departmental policy, and the anesthesiologist’s judgment govern actual care.