Commence NSAIDS on an individualized basis taking into account complexity and difficulty of surgery, age and renal function. (2B)

Regular acetaminophen dosing should be considered post-esophagectomy. (1B)

Paravertebral blocks are a good alternative to TEA following esophagectomy. (1B)

Thoracic epidural analgesia should be considered as first line approach to postoperative analgesia following esophagectomy. (1B)

Prolonged fasting should be avoided, and clear liquids, including specific preoperative high-carbohydrate drinks, should be allowed until 2 h prior to esophagectomy. (1A)

Antithrombotic prophylaxis with LMWH, together with mechanical measures, reduce the risk of VTE. Treatment should be started 2–12 h before the operation and should continue for 4 weeks after the operation. Epidural catheters should be placed no sooner than 12 h from the last LMWH does. LMWH should not be given until at least 4 h have passed after epidural catheter removal. (1A)

Prophylactic amiodarone may reduce the incidence of postoperative atrial fibrillation but current evidence does not support reduction in length of stay, overall morbidity or mortality in patients undergoing esophagectomy. Perioperative cardiac rhythm management strategies should be patient specific, aimed to reduce the modifiable risk factors and prompt recognition and treatment of associated or contributory complications. (1C)

Prophylactic beta-blockage for non-cardiac surgery reduces the incidence of postoperative myocardial infarction and supraventricular arrhythmias, but may potentially increase stroke, hypotension, bradycardia and even death. The beneficial effects seem to be cardiac-risk related, and are only seen in those with moderate to high cardiac risk. Current evidence supports continuing beta-blockers in the perioperative period in those who are chronically on beta-blockers and to prescribe beta-blockers for high-risk patients with coronary artery disease undergoing high risk non-cardiac operations. (1B)

Long-acting anxiolytics should be avoided, especially in the elderly, while short acting drugs may be used to reduce preoperative anxiety. (2B)

Nutritional assessment should be undertaken in all patients with a view to detecting and optimizing nutritional status before surgery. (1C)