Evaluation of enhanced recovery after surgery program components implemented in laparoscopic appendectomy: prospective randomized clinical study

Autor: T V Nechay, Alexander Tyagunov, Kirill Melnikov-Makarchuk, M V Anurov, S M Titkova, Alexander Sazhin, A E Tyagunov
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Visual analogue scale
lcsh:Medicine
Article
Perioperative Care
law.invention
03 medical and health sciences
Young Adult
Medical research
0302 clinical medicine
Postoperative Complications
Pneumoperitoneum
Randomized controlled trial
law
medicine
Appendectomy
Humans
Local anesthesia
Postoperative Period
Prospective Studies
Elective surgery
Laparoscopy
Prospective cohort study
Author Correction
lcsh:Science
Gastrointestinal diseases
Neck pain
Pain
Postoperative
Multidisciplinary
medicine.diagnostic_test
business.industry
lcsh:R
Length of Stay
Middle Aged
medicine.disease
Surgery
Elective Surgical Procedures
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Female
Peristalsis
lcsh:Q
medicine.symptom
business
Enhanced Recovery After Surgery
Zdroj: Scientific Reports, Vol 10, Iss 1, Pp 1-8 (2020)
Scientific Reports
ISSN: 2045-2322
DOI: 10.1038/s41598-020-67591-5
Popis: Background Laparoscopic appendectomy (LA) is a widely used surgical procedure. Patients often suffer from considerable postoperative pain and indigestion, which prolongs their in-hospital stay. Almost 10% of patients develop postoperative complications. The enhanced recovery after surgery (ERAS) program has proven its efficacy in elective surgery and could hypothetically improve LA outcomes. Currently, there is no ERAS program for LA. Methods A modified ERAS (mERAS) protocol was studied in a prospective, randomized nonblinded clinical trial. The mERAS group consisted of 50 patients; the control group, of 54 patients. The mERAS protocol included a patient information brochure; minimizing drain use; local anesthesia; low-pressure pneumoperitoneum; early mobilization and oral diet. The primary outcome was postoperative length of stay (pLOS). Results Modified protocol reduced median pLOS to 1.25 days vs 2 days in the controls (p p p p p = 0.0001), 1.98 ± 1.72 vs 3.43 ± 1.54 (p p = 0.032), respectively)]. The severity of shoulder and neck pain was lower but its incidence was similar. Peristalsis recovery was achieved earlier in the study group (median (min–max))—mERAS 7 (2–34) h vs control 11 (3–43) h; p = 0.009) but did not affect the time of the first flatus 23 (2–72) h vs 29 (6–70) h, respectively; p = 0.499). Conclusions The modified ERAS program for LA has advantages over the traditional approach. Registration This trial was registered at ClinicalTrials.gov as NCT03754777 (27/11/2018).
Databáze: OpenAIRE
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