scholarly journals Enhanced recovery after surgery: anesthesia-related components

2021 ◽  
Vol 64 (12) ◽  
pp. 813-819
Author(s):  
Ah-Reum Cho
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Postoperative Nausea And Vomiting ◽  
Perioperative Period ◽  
Temperature Management ◽  
Multidisciplinary Teams ◽  
Successful Implementation ◽  
Comprehensive Management ◽  
Care Processes ◽  
Essential Components

Background: Enhanced recovery after surgery (ERAS) is a multidisciplinary and multimodal evidence-based approach aimed at improving the recovery of surgical patients. Successful implementation of ERAS protocols requires proper perioperative communication and collaboration among surgeons, anesthesiologists, nurses, and other medical personnel.Current Concepts: The anesthesiologist is the clinical leader responsible for the ERAS program. Preoperative patient evaluation, optimization, and patient education are essential components of the ERAS program. The program also involves preoperative fasting and carbohydrate loading to minimize catabolic effects. Selection of an appropriate anesthetic regimen, fluid and temperature management, avoidance of intra/postoperative nausea and vomiting, and multimodal pain management are the key components of ERAS for which the anesthesiologist is responsible.Discussion and Conclusion: Factors that enable the successful implementation of ERAS include the willingness to change to ERAS, formation of multidisciplinary teams to improve cooperation, and support from the hospital management, as well as standardization of order sets and care processes and the appropriate use of audits. As the leader of the ERAS team, the anesthesiologist should be actively involved in comprehensive management of the patient during the perioperative period.

scholarly journals Developing implementation strategies to adopt Enhanced Recovery After Surgery (ERAS®) guidelines

BJS Open ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Jennifer Y Lam ◽  
Alexandra Howlett ◽  
Duncan McLuckie ◽  
Lori M Stephen ◽  
Scott D N Else ◽  
...  
Keyword(s):  
Implementation Strategy ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Healthcare Providers ◽  
Implementation Strategies ◽  
Multidisciplinary Teams ◽  
Successful Implementation ◽  
Care Pathways ◽  
Audit System ◽  
Local Contexts

Abstract Background Strong implementation strategies are critical to the success of Enhanced Recovery after Surgery (ERAS®) guidelines, though little documentation exists on effective strategies, especially in complex clinical situations and unfamiliar contexts. This study outlines the process taken to adopt a novel neonatal ERAS® guideline. Methods The implementation strategy was approached in a multi-pronged, concurrent but asynchronous fashion. Between September 2019 and January 2020, healthcare providers from various disciplines and different specialties as well as parents participated in the strategy. Multidisciplinary teams were created to consider existing literature and local contexts including potential facilitators and/or barriers. Task forces worked collaboratively to develop new care pathways. An audit system was developed to record outcomes and elicit feedback for revision. Results 32 healthcare providers representing 9 disciplines and 5 specialties as well as 8 parents participated. Care pathways and resources were created. Elements recommended for a successful implementation strategy included identification of champions, multidisciplinary stakeholder involvement, consideration of local contexts and insights, patient/family engagement, education, and creation of an audit system. Conclusion A multidisciplinary and structured process following principles of implementation science was used to develop an effective implementation strategy for initiating ERAS® guidelines.

scholarly journals Successful implementation of an Enhanced Recovery After Surgery (ERAS) protocol reduces nausea and vomiting in patients after infratentorial craniotomy: a randomized controlled trial

2019 ◽  
Author(s):  
Dan Lu ◽  
Yuan Wang ◽  
Tianzhi Zhao ◽  
Bolin Liu ◽  
Lin Ye ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Anxiety Level ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Successful Implementation ◽  
Eras Protocol

Abstract Objectives: Infratentorial craniotomy patients have a high incidence of postoperative nausea and vomiting (PONV). Enhanced Recovery After Surgery (ERAS) protocols have been shown in multiple surgical disciplines to improve outcomes, including reduced PONV. However, very few studies have described the application of ERAS to infratentorial craniotomy. The aim of this study was to examine whether our ERAS protocol for infratentorial craniotomy could improve PONV.Methods: We implemented an evidence-based, multimodal ERAS protocol for patients undergoing infratentorial craniotomy. A total of 105 patients who underwent infratentorial craniotomy were randomized into either the ERAS group (n = 50) or the control group (n = 55). Primary outcomes were the incidence of vomiting, nausea score, and use of rescue antiemetic during the first 72 h after surgery. Secondary outcomes included postoperative anxiety level, sleep quality, and complications.Results: Over the entire 72 h post-craniotomy observation period, the cumulative incidence of vomiting was significantly lower in the ERAS group than in the control group. Meanwhile, the incidence of vomiting was significantly lower in the ERAS group on postoperative days (PODs) 2 and 3. Notably, the proportion of patients with mild nausea (VAS 0-4) was higher in the ERAS group as compared to the control group on PODs 2 or 3. Additionally, the postoperative anxiety level and quality of sleep were significantly better in the ERAS group.Conclusion: Successful implementation of our ERAS protocol in infratentorial craniotomy patients could attenuate postoperative anxiety, improve sleep quality, and reduce the incidence of PONV, without increasing the rate of postoperative complications.

scholarly journals Successful implementation of an Enhanced Recovery After Surgery (ERAS) protocol reduces nausea and vomiting after infratentorial craniotomy for tumour resection: a randomized controlled trial

2020 ◽  
Author(s):  
Dan Lu ◽  
Yuan Wang ◽  
Tianzhi Zhao ◽  
Bolin Liu ◽  
Lin Ye ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Postoperative Nausea ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Postoperative Nausea And Vomiting ◽  
Anxiety Level ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Successful Implementation ◽  
Eras Protocol

Abstract BACKGROUND: Infratentorial craniotomy patients have a high incidence of postoperative nausea and vomiting (PONV). Enhanced Recovery After Surgery (ERAS) protocols have been shown in multiple surgical disciplines to improve outcomes, including reduced PONV. However, very few studies have described the application of ERAS to infratentorial craniotomy. The aim of this study was to examine whether our ERAS protocol for infratentorial craniotomy could improve PONV. METHODS: We implemented an evidence-based, multimodal ERAS protocol for patients undergoing infratentorial craniotomy. A total of 105 patients who underwent infratentorial craniotomy were randomized into either the ERAS group (n = 50) or the control group (n = 55). Primary outcomes were the incidence of vomiting, nausea score, and use of rescue antiemetic during the first 72 h after surgery. Secondary outcomes included postoperative anxiety level, sleep quality, and complications. RESULTS: Over the entire 72 h post-craniotomy observation period, the cumulative incidence of vomiting was significantly lower in the ERAS group than in the control group. Meanwhile, the incidence of vomiting was significantly lower in the ERAS group on postoperative days (PODs) 2 and 3. Notably, the proportion of patients with mild nausea (VAS 0-4) was higher in the ERAS group as compared to the control group on PODs 2 or 3. Additionally, the postoperative anxiety level and quality of sleep were significantly better in the ERAS group. CONCLUSION: Successful implementation of our ERAS protocol in infratentorial craniotomy patients could attenuate postoperative anxiety, improve sleep quality, and reduce the incidence of PONV, without increasing the rate of postoperative complications. TRIAL REGISTRATION: ChiCTR-INR-16009662, 27 Oct 2016, Clinical study on the development and efficacy evaluation of Enhanced Recovery After Surgery (ERAS) in Neurosurgery. KEYWORDS: enhanced recovery after surgery (ERAS), postoperative nausea and vomiting (PONV), infratentorial craniotomy, anxiety, sleep quality.

Effect of enhanced recovery after surgery management combined with nano-antibacterial dressing during perioperative nursing practice on rehabilitation of patients with gynecological tumor

2021 ◽  
Vol 11 (7) ◽  
pp. 1064-1070
Author(s):  
Hongping Wang ◽  
Lili Chen ◽  
Peiyang Chen ◽  
Wanwan Huang ◽  
Jianping Wang
Keyword(s):  
Nursing Care ◽  
Health Knowledge ◽  
Enhanced Recovery ◽  
Silver Content ◽  
Enhanced Recovery After Surgery ◽  
Gynecological Cancer ◽  
Self Care ◽  
Perioperative Period ◽  
Regular Group ◽  
Nano Silver

The nano-silver antibacterial dressing is processed and formed after being expanded and cut by medical degreased gauze and nano-silver solution. The nano-silver content is 0.4%–1.0% of the dressing mass (the nano-silver content per square meter of the dressing is 0.28–0.7 g). Nano silver plays an auxiliary role in reducing wound infections. This study is the first to report the rehabilitative effect of enhanced recovery after surgery (ERAS) management combined with nano antibacterial dressing in the perioperative period of gynecological cancer. The times until first exhaust, first defecation, ambulation, and the duration of hospitalization of the ERAS group were shorter than in the regular group. The VAS scores at 6 and 12 h after operation in the ERAS group were lower than those in the regular group. The levels of self-responsibility, self-concept, self-care skills, and health knowledge in the ERAS group were higher than those in the regular group. The total incidence of complications in the ERAS group was 9.09%, which was lower than that in the regular group (23.64%). The level of satisfaction with nursing care in the ERAS group was 98.18%, which was higher than that in the regular group (83.64%). The findings confirmed that ERAS combined with nano antibacterial dressing can promote the rehabilitation of patients, relieve pain, strengthen the self-care ability of patients, reduce the occurrence of complications, and improve satisfaction with nursing care.

The Application of Enhanced Recovery After Surgery and Negative-Pressure Wound Therapy in The Perioperative Period of Elderly Patients With Colorectal Cancer

2020 ◽  
Author(s):  
Hanrong Liu ◽  
Ping Yang ◽  
Song Han ◽  
Yu Zhang ◽  
Hui-ying Zhu
Keyword(s):  
Colorectal Cancer ◽  
Wound Healing ◽  
Negative Pressure ◽  
Wound Dressing ◽  
Readmission Rate ◽  
Negative Pressure Wound Therapy ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Perioperative Period ◽  
Wound Therapy

Abstract Objective: To Explore the perioperative application of enhanced recovery after surgery (ERAS) and negative-pressure wound therapy in the elderly patients with colorectal cancer. Methods: A retrospective clinical data were studied in the patients with colorectal cancer in Department of General Surgery in Shanghai Forth People,s Hospital (from March, 2017 to March, 2019), One hundred and fifty patients with undergoing radical surgery for colorectal cancer were divided into two groups: ERAS group(n=76 cases, accepting ERAS management) and Conventional treatment(CT) group(n=74 cases, accepting traditional treatment),Bleeding in operation, the time of postoperative anal flatus ,number of wound dressing changing, time of wound healing, the length of postoperative hospital stay, readmission rate, postoperative complication, were compared between the two groups. Results: ERAS was associated with less bleeding in operation, less Wound fat liquefaction, less wound dressing changing, less time of wound healing，less time of postoperative anal flatus compare to CT group（P<0.05）; anastomotic fistula、readmission rate is similar in two groups（P>0.05）. Conclusion: The modified ERAS can be safely applied to the perioperative period of elderly colorectal cancer patients and promote recovery; negative-pressure wound therapy is helpful for wound healing and promoting rehabilitation.

scholarly journals "RETRACTED ARTICLE:Successful implementation of an enhanced recovery after surgery (ERAS) protocol reduces nausea and vomiting after infratentorial craniotomy for tumour resection: a randomized controlled trial

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Dan Lu ◽  
Yuan Wang ◽  
Tianzhi Zhao ◽  
Bolin Liu ◽  
Lin Ye ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Controlled Trial ◽  
Anxiety Level ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Tumour Resection ◽  
Successful Implementation ◽  
Eras Protocol

Abstract Background Infratentorial craniotomy patients have a high incidence of postoperative nausea and vomiting (PONV). Enhanced Recovery After Surgery (ERAS) protocols have been shown in multiple surgical disciplines to improve outcomes, including reduced PONV. However, very few studies have described the application of ERAS to infratentorial craniotomy. The aim of this study was to examine whether our ERAS protocol for infratentorial craniotomy could improve PONV. Methods We implemented an evidence-based, multimodal ERAS protocol for patients undergoing infratentorial craniotomy. A total of 105 patients who underwent infratentorial craniotomy were randomized into either the ERAS group (n = 50) or the control group (n = 55). Primary outcomes were the incidence of vomiting, nausea score, and use of rescue antiemetic during the first 72 h after surgery. Secondary outcomes included postoperative anxiety level, sleep quality, and complications. Results Over the entire 72 h post-craniotomy observation period, the cumulative incidence of vomiting was significantly lower in the ERAS group than in the control group. Meanwhile, the incidence of vomiting was significantly lower in the ERAS group on postoperative days (PODs) 2 and 3. Notably, the proportion of patients with mild nausea (VAS 0–4) was higher in the ERAS group as compared to the control group on PODs 2 or 3. Additionally, the postoperative anxiety level and quality of sleep were significantly better in the ERAS group. Conclusion Successful implementation of our ERAS protocol in infratentorial craniotomy patients could attenuate postoperative anxiety, improve sleep quality, and reduce the incidence of PONV, without increasing the rate of postoperative complications. Trial registration ChiCTR-INR-16009662, 27 Oct 2016, Clinical study on the development and efficacy evaluation of Enhanced Recovery After Surgery (ERAS) in Neurosurgery.

scholarly journals Successful implementation of an Enhanced Recovery After Surgery (ERAS) protocol reduces nausea and vomiting in patients after infratentorial craniotomy for tumour resection: a randomized controlled trial.

2019 ◽  
Author(s):  
Dan Lu ◽  
Yuan Wang ◽  
Tianzhi Zhao ◽  
Bolin Liu ◽  
Lin Ye ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Controlled Trial ◽  
Anxiety Level ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Tumour Resection ◽  
Successful Implementation ◽  
Eras Protocol

Abstract Objectives: Infratentorial craniotomy patients have a high incidence of postoperative nausea and vomiting (PONV). Enhanced Recovery After Surgery (ERAS) protocols have been shown in multiple surgical disciplines to improve outcomes, including reduced PONV. However, very few studies have described the application of ERAS to infratentorial craniotomy. The aim of this study was to examine whether our ERAS protocol for infratentorial craniotomy could improve PONV. Methods: We implemented an evidence-based, multimodal ERAS protocol for patients undergoing infratentorial craniotomy. A total of 105 patients who underwent infratentorial craniotomy were randomized into either the ERAS group (n = 50) or the control group (n = 55). Primary outcomes were the incidence of vomiting, nausea score, and use of rescue antiemetic during the first 72 h after surgery. Secondary outcomes included postoperative anxiety level, sleep quality, and complications. Results: Over the entire 72 h post-craniotomy observation period, the cumulative incidence of vomiting was significantly lower in the ERAS group than in the control group. Meanwhile, the incidence of vomiting was significantly lower in the ERAS group on postoperative days (PODs) 2 and 3. Notably, the proportion of patients with mild nausea (VAS 0-4) was higher in the ERAS group as compared to the control group on PODs 2 or 3. Additionally, the postoperative anxiety level and quality of sleep were significantly better in the ERAS group. Conclusion: Successful implementation of our ERAS protocol in infratentorial craniotomy patients could attenuate postoperative anxiety, improve sleep quality, and reduce the incidence of PONV, without increasing the rate of postoperative complications.

scholarly journals The application of enhanced recovery after surgery and negative-pressure wound therapy in the perioperative period of elderly patients with colorectal cancer

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Han-rong Liu ◽  
Ping Yang ◽  
Song Han ◽  
Yu Zhang ◽  
Hui-yin Zhu
Keyword(s):  
Colorectal Cancer ◽  
Wound Healing ◽  
Negative Pressure ◽  
Wound Dressing ◽  
Readmission Rate ◽  
Negative Pressure Wound Therapy ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Perioperative Period ◽  
Wound Therapy

Abstract Objective To Explore the perioperative application of enhanced recovery after surgery (ERAS) and negative-pressure wound therapy in the elderly patients with colorectal cancer. Methods A retrospective clinical data were studied in the patients with colorectal cancer in Department of General Surgery in Shanghai Fourth People,s Hospital (from March, 2017 to March, 2019), One hundred and fifty patients with undergoing radical surgery for colorectal cancer were divided into two groups: ERAS group (n = 76 cases, accepting ERAS management) and Conventional treatment(CT) group (n = 74 cases, accepting traditional treatment), Bleeding in operation, the time of postoperative anal flatus, number of wound dressing changing, time of wound healing, the length of postoperative hospital stay, readmission rate, postoperative complication, were compared between the two groups. Results ERAS was associated with less bleeding in operation, less Wound fat liquefaction, less wound dressing changing, less time of wound healing, less time of postoperative anal flatus compare to CT group (P < 0.05); anastomotic fistula, readmission rate is similar in two groups (P > 0.05). Conclusion The modified ERAS can be safely applied to the perioperative period of elderly colorectal cancer patients and promote recovery; negative-pressure wound therapy is helpful for wound healing and promoting rehabilitation.

Sign in / Sign up

Export Citation Format

Share Document