Implementation of modified enhanced recovery after surgery (ERAS) following surgery for abdominal trauma; Assessment of feasibility and outcomes: A randomized controlled trial (RCT).

Autor: Jain V; Department of General Surgery, Post Graduate Institute of Medical Education and Research, Sector 12, 160012, Chandigarh, India., Irrinki S; Department of General Surgery, Post Graduate Institute of Medical Education and Research, Sector 12, 160012, Chandigarh, India., Khare S; Department of General Surgery, Post Graduate Institute of Medical Education and Research, Sector 12, 160012, Chandigarh, India., Kurdia KC; Department of General Surgery, Post Graduate Institute of Medical Education and Research, Sector 12, 160012, Chandigarh, India. Electronic address: drkurdia@gmail.com., Nagaraj SS; Department of General Surgery, Post Graduate Institute of Medical Education and Research, Sector 12, 160012, Chandigarh, India., Sakaray YR; Department of General Surgery, Post Graduate Institute of Medical Education and Research, Sector 12, 160012, Chandigarh, India., Savlania A; Department of General Surgery, Post Graduate Institute of Medical Education and Research, Sector 12, 160012, Chandigarh, India., Tandup C; Department of General Surgery, Post Graduate Institute of Medical Education and Research, Sector 12, 160012, Chandigarh, India., Verma P; Department of Anesthesia, Post Graduate Institute of Medical Education and Research, Sector 12, 160012, Chandigarh, India., Kaman L; Department of General Surgery, Post Graduate Institute of Medical Education and Research, Sector 12, 160012, Chandigarh, India.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2024 Dec; Vol. 238, pp. 115975. Date of Electronic Publication: 2024 Sep 19.
DOI: 10.1016/j.amjsurg.2024.115975
Abstrakt: Background: Enhanced recovery after surgery(ERAS) is a set of multiple perioperative care component not a rigid protocol with improved outcomes for elective surgeries. This study aimed to assess the feasibility and outcomes in trauma patients undergoing laparotomy.
Study Design: Prospective single-centre randomized controlled trial(RCT). Patients undergoing emergency laparotomy following trauma were randomized into ERAS(early removal of catheters, early mobilization and initiation of diet, use of opioid-sparing multimodal analgesia) and conventional care groups 24 ​h post-surgery. Outcome measures included length of hospitalization(LOH), recovery of bowel function, duration of removal of catheters and 30-day complications(Clavien-Dindo).
Results: Fifty patients were randomized into ERAS(n ​= ​25) and conventional care(n ​= ​25) groups. Ninety-two percent of patients were young males, 58 ​% had blunt trauma to the abdomen and the most common indication of surgery was hollow viscus injury(88 ​%). ERAS group had a reduced median LOH(days) (6 versus 8, p ​= ​0.007), early recovery of bowel function(p ​= ​0.010) and shorter times for nasogastric tube(p ​= ​0.001), urinary catheter(p ​= ​0.007) and drain(p ​= ​0.006) removal. The complications were comparable in both groups except for deep surgical site infection[significantly lower in ERAS group(p ​= ​0.009)].
Conclusion: ERAS is safe and significantly reduces LOH in select trauma patients undergoing laparotomy.
Competing Interests: Declaration of competing interest The authors have nothing to declare.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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