Effects of “Enhanced Recovery After Surgery” Protocol on Outcome of Surgical Patients

Abstract

Objective: To provide evidence that application of Enhanced Recovery after Surgery Protocol can promote rapid recovery of surgical patients in addition to reduction of duration of hospital stay. Study Design: Quasi-experimental study. Place and Duration of Study: Sheikh Khalifa Bin Zayad Alnayan Hospital, Rawalakot Azad Kashmir Pakistan, from Jan 2019 to Jun 2020. Methodology: Respondents included 210 surgical patients from discipline of Otorhinolaryngology, General Surgery, Urology, Gynecology and Obstetrics. Patients were randomly divided into two equal groups by odd and even numbers. Group-A included 105 surgical patients who were managed by conventional protocol. Group-B included 105 surgical patients who were managed by Enhanced Recovery after Surgery Protocol. Results: Enhanced Recovery after Surgery Group (Group-B) was found to have shorter preoperative fasting time (146.4±0.47 vs 633.6±1.55 minutes, p<0.001), reduced postoperative fasting time (139.2±0.41 vs 360±0.09 minutes, p<0.001), less use of intravenous fluid (870±0.5 vs 2480ml, p<0.001) and reduced hospital stay (52.8±0.91 vs 80.16±1.17 hours, p<0.001) as compared to Traditional Group. Compared to traditional group (Group-A), the number of highly satisfied patients were more in Group-B (n-95 or 90.48% vs n-42 or 40%, p-value<0.001). No significant difference was noted in post-operative vomiting, surgical wound infection and rate of re-admission among both groups. Conclusion: There is a significant reduction in duration of hospital stay and swift recovery after surgery, leading to reductions in treatment cost and resource utilization.

Keywords

• Enhanced Recovery after Surgery (ERAS) Protocol, Minimal Invasive Surgery, Multi-Modal Non-Opioid Analgesia, Patient Satisfaction.