scholarly journals Enhanced recovery after surgery: operation-related factors

2021 ◽  
Vol 64 (12) ◽  
pp. 806-812
Author(s):  
Dae Wook Hwang
Keyword(s):  
Perioperative Care ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Surgical Stress ◽  
Antimicrobial Prophylaxis ◽  
Early Mobilization ◽  
Evidence Based ◽  
Complication Rates ◽  
Related Factors ◽  
Urinary Drainage

Background: The enhanced recovery after surgery (ERAS) program, which has been recently introduced in the field of perioperative care, represents a multimodal strategy to attenuate the loss, and improve the restoration, of functional capacity after surgery. This program aims to reduce morbidity and enhance recovery by reducing surgical stress, optimizing pain control, and facilitating early resumption of an oral diet and early mobilization. Considering this perspective, protocols for enhanced recovery should include comprehensive and evidence-based guidelines for best perioperative care. Appropriate protocol implementation may reduce complication rates and enhance functional recovery and thereby reduce the duration of hospitalization.Current Concepts: In major abdominal surgeries, the recommended ERAS protocols involve common items such as preoperative counseling, preoperative optimization, prehabilitation, preoperative nutrition, fasting and carbohydrate loading, bowel preparation, thromboprophylaxis, antimicrobial prophylaxis, surgical access, drainage, nasogastric intubation, urinary drainage, early mobilization and prevention of postoperative ileus, postoperative glycemic control, and postoperative nutritional care. These items have been briefly reviewed with the relevant evidence.Discussion and Conclusion: ERAS is a comprehensive and evidence-based guideline for optimal perioperative care. Although a number of ERAS items still require high-level evidence through well-designed randomized controlled trials, the ERAS guidelines can serve as adequate recommendations for our practice. Thus, these items can be introduced and adopted with evidence. In addition, it is important to remove items that are not supported by evidence from routine procedures.

scholarly journals Penerapan Enhanced Recovery after Surgery (ERAS) pada Bedah Saraf

2021 ◽  
Vol 10 (2) ◽  
pp. 144-150
Author(s):  
Riyadh Firdhaus ◽  
◽  
Affan Priyambodo Permana ◽  
Astrid Indrafebrina Sugianto ◽  
Sandy Theresia ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Antimicrobial Prophylaxis ◽  
Fluid Management ◽  
Treatment Protocol ◽  
Early Mobilization ◽  
Anesthetic Technique ◽  
Intraoperative Care ◽  
Urinary Drainage ◽  
Eras Protocol

Enhanced recovery after surgery (ERAS) is a multidisciplinary standardized perioperative treatment protocol in surgical patients that aims to minimize perioperative stress and result in better outcomes. The ERAS protocol is composed of various components of care that have been shown to support recovery and/or avoid postoperative complications. These components include surgeons, anesthesiologists, nurses, pharmacists, nutritionists who are involved in patient care to provide better improvements. The ERAS protocol is composed of various components of preoperative care (counseling, nutrition, lifestyle management, thromboprophylaxis, preparation of the surgical area and antimicrobial prophylaxis), intraoperative care (anesthetic technique, anesthesia management, analgesia, fluid management, temperature regulation, surgical technique) and postoperative care (PONV management, urinary drainage, nutritional intake, early mobilization). Implementation of ERAS is applicable and shows good results along with the benefits for patients undergoing neurosurgery. However, ERAS in neurosurgery is still very limited and requires further research following different types of procedures / operations and different patient conditions.

scholarly journals Impact of enhanced recovery after surgery protocol compliance on patients’ outcome in benign hysterectomy and establishment of a predictive nomogram model

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yiwei Shen ◽  
Feng Lv ◽  
Su Min ◽  
Gangming Wu ◽  
Juying Jin ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Complications ◽  
Length Of Stay ◽  
Postoperative Complication ◽  
Patient Experience ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Early Mobilization ◽  
Urinary Drainage ◽  
Eras Protocol

Abstract Background Enhanced recovery after surgery (ERAS) pathways have been shown to improve clinical outcomes after surgery. Considering the importance of patient experience for patients with benign surgery, this study evaluated whether improved compliance with ERAS protocol modified for gynecological surgery which recommended by the ERAS Society is associated with better clinical outcomes and patient experience, and to determine the influence of compliance with each ERAS element on patients’ outcome after benign hysterectomy. Methods A prospective observational study was performed on the women who underwent hysterectomy between 2019 and 2020. A total of 475 women greater 18 years old were classified into three groups according to their per cent compliance with ERAS protocols: Group I: < 60% (148 cases); Group II:≥60 and < 80% (160 cases); Group III: ≥80% (167 cases). Primary outcome was the 30-day postoperative complications. Second outcomes included QoR-15 questionnaire scores, patient satisfaction on a scale from 1 to 7, and length of stay after operation. After multivariable binary logistic regression analyse, a nomogram model was established to predict the incidence of having a postoperative complication with individual ERAS element compliance. Results The study enrolled 585 patients, and 475 completed the follow-up assessment. Patients with compliance over 80% had a significant reduction in postoperative complications (20.4% vs 41.2% vs 38.1%, P < 0.001) and length of stay after surgery (4 vs 5 vs 4, P < 0.001). Increased compliance was also associated with higher patient satisfaction and QoR-15 scores (P < 0.001),. Among the five dimensions of the QoR-15, physical comfort (P < 0.05), physical independence (P < 0.05), and pain dimension (P < 0.05) were better in the higher compliance groups. Minimally invasive surgery (MIS) (P < 0.001), postoperative nausea and vomiting (PONV) prophylaxis (P < 0.001), early mobilization (P = 0.031), early oral nutrition (P = 0.012), and early removal of urinary drainage (P < 0.001) were significantly associated with less complications. Having a postoperative complication was better predicted by the proposed nomogram model with high AUC value (0.906) and sensitivity (0.948) in the cohort. Conclusions Improved compliance with the ERAS protocol was associated with improved recovery and better patient experience undergoing hysterectomy. MIS, PONV prophylaxis, early mobilization, early oral intake, and early removal of urinary drainage were of concern in reducing postoperative complications. Trial registration Chinese Clinical Trial Registry, ChiCTR1800019178. Registered on 30/10/2018.

scholarly journals Smartband use during enhanced recovery after surgery facilitates inpatient recuperation following minimally invasive colorectal surgery

2020 ◽  
Author(s):  
Tzu-Chieh Yin ◽  
Ching-Wen Huang ◽  
Hsiang-Lin Tsai ◽  
Wei-Chih Su ◽  
Cheng-Jen Ma ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Minimally Invasive ◽  
Perioperative Care ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Early Mobilization ◽  
Quality Of Recovery ◽  
Hospital Stays ◽  
Minimally Invasive Colorectal Surgery

Abstract Background Enhanced recovery after surgery (ERAS) is valuable in perioperative care for its ability to improve short-term surgical outcomes and facilitate patient recuperation after major surgery. Early postoperative mobilization is a vital component of the integrated care pathway and is a factor strongly associated with successful outcomes. However, early mobilization still has various definitions and lacks specific strategies. Methods Patients who underwent minimally invasive surgery for colorectal cancer followed our perioperative ERAS program, including mobilization from the first postoperative day. After perioperative care skills were improved in our well-established program, compliance, inpatient surgical outcomes, and complications associated with adding smartband use were evaluated and compared with the outcomes for standard protocol. Quality of recovery was evaluated using patient-rated QoR-40 questionnaires the day before surgery, on postoperative day 1 and 3, and on the day of discharge. Results Smartband use after minimally invasive colorectal surgery failed to increase compliance with early mobilization or reduce the occurrence of postoperative complications significantly compared with standard ERAS protocol. However, when smartbands were utilized, quality of recovery was optimized and patients returned to their preoperative status earlier, at postoperative day 3. The duration of theoretical hospital stays and hospital stays of uncomplicated patients wearing smartbands was also reduced by 1.1 and 0.9 days, respectively ( P = 0.0091 and 0.049). Conclusions Smartbands enable enhanced communication between patients and surgical teams and strengthen self-management in patients undergoing minimally invasive colorectal resection surgery. Accelerated recovery to preoperative functional status can be facilitated by integrating smartbands into the process of early mobilization during ERAS.

scholarly journals Enhanced recovery after surgery: Neuroanaesthetic perspective

2017 ◽  
Vol 04 (01) ◽  
pp. 017-022
Author(s):  
Rajeeb Mishra ◽  
Indu Kapoor ◽  
Charu Mahajan ◽  
Hemanshu Prabhakar
Keyword(s):  
Patient Care ◽  
Perioperative Care ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Surgical Stress ◽  
Integrated Approach ◽  
Basic Knowledge ◽  
Early Recovery ◽  
Outcome Of Surgery

AbstractEnhanced recovery after surgery (ERAS) is a systematic multimodal perioperative care aimed at reducing the immense surgical stress of the patient and thereby facilitating early recovery. This is basically a multidiscipline, multimodal integrated approach in patient care and it integrates the basic knowledge in a more streamlined fashion, which ultimately improves the outcome of surgery. This article reviews the various aspects of ERAS, and its implementation in neurosurgical practice as some concepts of ERAS may not be applicable in the setting of neurosurgery.

scholarly journals Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update

2022 ◽  
Author(s):  
Erik Stenberg ◽  
Luiz Fernando dos Reis Falcão ◽  
Mary O’Kane ◽  
Ronald Liem ◽  
Dimitri J. Pournaras ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Perioperative Care ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Assessment Development ◽  
Meta Analyses ◽  
Large Prospective Cohort

Abstract Background This is the second updated Enhanced Recovery After Surgery (ERAS®) Society guideline, presenting a consensus for optimal perioperative care in bariatric surgery and providing recommendations for each ERAS item within the ERAS® protocol. Methods A principal literature search was performed utilizing the Pubmed, EMBASE, Cochrane databases and ClinicalTrials.gov through December 2020, with particular attention paid to meta-analyses, randomized controlled trials and large prospective cohort studies. Selected studies were examined, reviewed and graded according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. After critical appraisal of these studies, the group of authors reached consensus regarding recommendations. Results The quality of evidence for many ERAS interventions remains relatively low in a bariatric setting and evidence-based practices may need to be extrapolated from other surgeries. Conclusion A comprehensive, updated evidence-based consensus was reached and is presented in this review by the ERAS® Society.

scholarly journals Smartband use during enhanced recovery after surgery facilitates inpatient recuperation following minimally invasive colorectal surgery

2020 ◽  
Author(s):  
Tzu-Chieh Yin ◽  
Ching-Wen Huang ◽  
Hsiang-Lin Tsai ◽  
Wei-Chih Su ◽  
Cheng-Jen Ma ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Minimally Invasive ◽  
Perioperative Care ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Early Mobilization ◽  
Quality Of Recovery ◽  
Hospital Stays ◽  
Minimally Invasive Colorectal Surgery

Abstract BackgroundEnhanced recovery after surgery (ERAS) is valuable in perioperative care for its ability to improve short-term surgical outcomes and facilitate patient recuperation after major surgery. Early postoperative mobilization is a vital component of the integrated care pathway and is a factor strongly associated with successful outcomes. However, early mobilization still has various definitions and lacks specific strategies.MethodsPatients who underwent minimally invasive surgery for colorectal cancer followed our perioperative ERAS program, including mobilization from the first postoperative day. After perioperative care skills were improved in our well-established program, compliance, inpatient surgical outcomes, and complications associated with adding smartband use were evaluated and compared with the outcomes for standard protocol. Quality of recovery was evaluated using patient-rated QoR-40 questionnaires the day before surgery, on postoperative day 1 and 3, and on the day of discharge.ResultsSmartband use after minimally invasive colorectal surgery failed to increase compliance with early mobilization or reduce the occurrence of postoperative complications significantly compared with standard ERAS protocol. However, when smartbands were utilized, quality of recovery was optimized and patients returned to their preoperative status earlier, at postoperative day 3. The duration of theoretical hospital stays and hospital stays of uncomplicated patients wearing smartbands was also reduced by 1.1 and 0.9 days, respectively (P = 0.0091 and 0.049).ConclusionsSmartbands enable enhanced communication between patients and surgical teams and strengthen self-management in patients undergoing minimally invasive colorectal resection surgery. Accelerated recovery to preoperative functional status can be facilitated by integrating smartbands into the process of early mobilization during ERAS.

Enhanced Recovery Pathways: Organization of Evidence-Based, Fast-Track Perioperative Care

2013 ◽  
Author(s):  
Liane S. Feldman ◽  
Gabriele Baldini ◽  
Lawrence Lee ◽  
Franco Carli
Keyword(s):  
Perioperative Care ◽  
Enhanced Recovery ◽  
Surgical Stress ◽  
Fluid Management ◽  
Mechanical Bowel Preparation ◽  
Care Plan ◽  
Evidence Based ◽  
Care Plans ◽  
Enhanced Recovery Pathways ◽  
Recovery Pathways

Enhanced recovery pathways (ERPs) are standardized coordinated, multidisciplinary perioperative care plans that incorporate evidence-based interventions to minimize surgical stress, improve physiologic and functional recovery, reduce complications, and thereby facilitate earlier discharge from the hospital. Several perioperative elements contribute to enhance surgical recovery. Preoperative elements include patient education, optimization of medical conditions and functional status, nutritional support, smoking cessation programs, minimization of preoperative fasting and preoperative carbohydrate drinks, avoidance of mechanical bowel preparation when not indicated, and avoidance of long-active sedatives as premedication. Intraoperative elements aim to attenuate the surgical stress response and include regional or local anesthesia; pharmacologic adjuvants, nonopioid analgesics, and maintaining normothermia; intravenous fluid management; and opting to favor small incisions when possible. Postoperative elements include considering multimodal analgesia (opioid-sparing strategies); encouraging early postoperative feeding; stressing the importance of early mobilization; restricting the unnecessary use of intravenous fluids, drains, and catheters; and instituting a discharge and follow-up plan for patients. Tables describe the evolution of intraoperative fluid management, organization of a multimodal perioperative care plan for a specific procedure or group of procedures; key elements to include in developing an ERP; sample multimodal perioperative care plans for elective colorectal resection, esophageal resection, and ambulatory laparoscopic cholecystectomy. This review contains 1 figure, 6 tables, and 319 references.

Enhanced Recovery Pathways: Organization of Evidence-Based, Fast-Track Perioperative Care

2013 ◽  
Author(s):  
Liane S. Feldman ◽  
Gabriele Baldini ◽  
Lawrence Lee ◽  
Franco Carli
Keyword(s):  
Perioperative Care ◽  
Enhanced Recovery ◽  
Surgical Stress ◽  
Fluid Management ◽  
Mechanical Bowel Preparation ◽  
Care Plan ◽  
Evidence Based ◽  
Care Plans ◽  
Enhanced Recovery Pathways ◽  
Recovery Pathways

Enhanced recovery pathways (ERPs) are standardized coordinated, multidisciplinary perioperative care plans that incorporate evidence-based interventions to minimize surgical stress, improve physiologic and functional recovery, reduce complications, and thereby facilitate earlier discharge from the hospital. Several perioperative elements contribute to enhance surgical recovery. Preoperative elements include patient education, optimization of medical conditions and functional status, nutritional support, smoking cessation programs, minimization of preoperative fasting and preoperative carbohydrate drinks, avoidance of mechanical bowel preparation when not indicated, and avoidance of long-active sedatives as premedication. Intraoperative elements aim to attenuate the surgical stress response and include regional or local anesthesia; pharmacologic adjuvants, nonopioid analgesics, and maintaining normothermia; intravenous fluid management; and opting to favor small incisions when possible. Postoperative elements include considering multimodal analgesia (opioid-sparing strategies); encouraging early postoperative feeding; stressing the importance of early mobilization; restricting the unnecessary use of intravenous fluids, drains, and catheters; and instituting a discharge and follow-up plan for patients. Tables describe the evolution of intraoperative fluid management, organization of a multimodal perioperative care plan for a specific procedure or group of procedures; key elements to include in developing an ERP; sample multimodal perioperative care plans for elective colorectal resection, esophageal resection, and ambulatory laparoscopic cholecystectomy. This review contains 1 figure, 6 tables, and 319 references.

scholarly journals Smartband use during enhanced recovery after surgery facilitates inpatient recuperation following minimally invasive colorectal surgery

2020 ◽  
Author(s):  
Tzu-Chieh Yin ◽  
Ching-Wen Huang ◽  
Hsiang-Lin Tsai ◽  
Wei-Chih Su ◽  
Cheng-Jen Ma ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Minimally Invasive ◽  
Perioperative Care ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Early Mobilization ◽  
Quality Of Recovery ◽  
Hospital Stays ◽  
Minimally Invasive Colorectal Surgery

Abstract Background Enhanced recovery after surgery (ERAS) is valuable in perioperative care for its ability to improve short-term surgical outcomes and facilitate patient recuperation after major surgery. Early postoperative mobilization is a vital component of the integrated care pathway and is a factor strongly associated with successful outcomes. However, early mobilization still has various definitions and lacks specific strategies. Methods Patients who underwent minimally invasive surgery for colorectal cancer followed our perioperative ERAS program, including mobilization from the first postoperative day. After perioperative care skills were improved in our well-established program, compliance, inpatient surgical outcomes, and complications associated with adding smartband use were evaluated and compared with the outcomes for standard protocol. Quality of recovery was evaluated using patient-rated QoR-40 questionnaires the day before surgery, on postoperative day 1 and 3, and on the day of discharge. Results Smartband use after minimally invasive colorectal surgery failed to increase compliance with early mobilization or reduce the occurrence of postoperative complications significantly compared with standard ERAS protocol. However, when smartbands were utilized, quality of recovery was optimized and patients returned to their preoperative status earlier, at postoperative day 3. The duration of theoretical hospital stays and hospital stays of uncomplicated patients wearing smartbands was also reduced by 1.1 and 0.9 days, respectively ( P = 0.0091 and 0.049). Conclusions Smartbands enable enhanced communication between patients and surgical teams and strengthen self-management in patients undergoing minimally invasive colorectal resection surgery. Accelerated recovery to preoperative functional status can be facilitated by integrating smartbands into the process of early mobilization during ERAS.

Sign in / Sign up

Export Citation Format

Share Document