International Journal of General Medicine (Jul 2021)

How Much Benefit Can Patients Acquire from Enhanced Recovery After Surgery Protocols with Percutaneous Endoscopic Lumbar Interbody Fusion?

  • Gong J,
  • Luo L,
  • Liu H,
  • Li C,
  • Tang Y,
  • Zhou Y

Journal volume & issue
Vol. Volume 14
pp. 3125 – 3132

Abstract

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Junfeng Gong,* Liwen Luo,* Huan Liu, Changqing Li, Yu Tang, Yue Zhou Department of Orthopedics, The Second Affiliated Xinqiao Hospital of Army Military Medical University, Chongqing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yue Zhou; Yu TangDepartment of Orthopedics, The Second Affiliated Xinqiao Hospital of Army Military Medical University, Xinqiao Street, Shapingba District, Chongqing, People’s Republic of ChinaTel +86 13908390792; +86 18623422628Fax +86 23-68755012Email [email protected]; [email protected]: We aimed to explore the role of enhanced recovery after surgery (ERAS) in patients who underwent percutaneous endoscopic lumbar interbody fusion (PELIF).Patients and Methods: We performed a retrospective, observational, cohort study on 91 patients who underwent PELIF for degenerative disc disease. The primary outcomes were postoperative opioid consumption, hospital length of stay (LOS), and hospital cost.Results: Forty-six patients comprised the ERAS group, and 45 patients comprised the pre-ERAS group (control group). The groups had comparable demographic characteristics. Good compliance with the ERAS pathway was observed in the ERAS group. Patients in the ERAS group used significantly fewer morphine equivalents compared with the pre-ERAS group (25.0 vs 33.3, respectively; p = 0.017). Hospital LOS did not decrease significantly in the ERAS group compared with the pre-ERAS group (3.1days vs 3.4 days, respectively; p = 0.096). Likewise, there was no significant difference in hospital cost between the pre-ERAS group and the ERAS group ($10,598.60 vs $10,384.50, respectively; p = 0.468).Conclusion: In the present study, the benefit of ERAS in the context of PELIF was limited. Although a multidisciplinary ERAS protocol can improve analgesia and decrease opioid consumption, no significant reduction in hospital LOS and cost was observed.Keywords: enhanced recovery after surgery, hospital length of stay, opioid use, hospital costs, percutaneous endoscopic spine surgery

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