Successful implementation of an enhanced recovery after surgery (ERAS) protocol reduces nausea and vomiting after infratentorial craniotomy for tumour resection: a randomized controlled trial
| Autor: | Zhengmin Li, Dan Lu, Xude Sun, Long Chen, Shiming He, Jiangtao Niu, Yuan Wang, Tianzhi Zhao, Yufu Zhang, Yafei Xue, Binfang Zhao, Tao Zheng, Wenhai Lv, Mingjuan Li, Lanfu Zhao, Lei Chen, Lin Ye, Bo Chen, Guodong Gao, Lin Ma, Bolin Liu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Nausea medicine.drug_class medicine.medical_treatment Anxiety lcsh:RC346-429 law.invention Enhanced recovery after surgery (ERAS) 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Antiemetic Humans Cumulative incidence lcsh:Neurology. Diseases of the nervous system Craniotomy business.industry Brain Neoplasms General Medicine Sleep quality Surgery Postoperative nausea and vomiting (PONV) Infratentorial craniotomy Retraction Note 030220 oncology & carcinogenesis Postoperative Nausea and Vomiting Vomiting Neurology (clinical) Neurosurgery medicine.symptom business Enhanced Recovery After Surgery 030217 neurology & neurosurgery Postoperative nausea and vomiting Research Article |
| Zdroj: | BMC Neurology BMC Neurology, Vol 20, Iss 1, Pp 1-11 (2020) |
| ISSN: | 1471-2377 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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