THE SURGICAL STRESS response has been described as a feature shared by all patients who undergo surgery and a major contributing factor to postoperative morbidity.1 Prolonged stress response can cause widespread alteration in organ function and erode cell mass and physiologic reserve.2 and 3 Subsequent adverse effects include gastrointestinal (GI) dysfunction and ileus, hypoxemia, fatigue, muscle wasting, impaired cognition, and cardiopulmonary, infectious, and thromboembolic complications.2, 3 and 4 Any one of these events can delay hospital discharge, extend convalescence, and negatively impact long-term prognosis