Implementation of an ERAS program in patients undergoing thoracic surgery at a third-level university hospital: an ambispective cohort study

Bellas-Cotán, Soledad; Casans‐Francés, Rubén; Ibáñez, Cristina; Muguruza, Ignacio; Muñoz-Alameda, Luis E.

doi:10.1016/j.bjane.2021.04.014

Cited by 3 publications

(5 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients undergoing thoracic surgery have many psychological and physiological stressors. Recovery strategies have been developed to help them return to their baseline lives as soon as possible [ 4 , 16 ]. The European Society of Thoracic Surgeons and Enhanced Recovery After Surgery have published guidelines on enhanced recovery and perioperative management of patients undergoing thoracic surgery [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of mobilization in the first hour following uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax

Unaldi

2024

kitp

View full text Add to dashboard Cite

Introduction: Although primary spontaneous pneumothorax is a common disease in young adults, each thoracic surgery department performs different procedures for its management. Aim: The optimal time of postoperative mobilization is not yet standardized in lung surgery. Material and methods: This study included male patients with a primary spontaneous pneumothorax who underwent wedge resection of the upper lobe of the lungs via uniportal video-assisted thoracoscopic surgery. Patients were encouraged to stand up within the first postoperative hour. Mobilization was defined as standing and walking at least 100 m from the bed. If orthostatic hypotension occurred, mobilization was postponed for 30 min. Immediately after surgery, intravenous fluids were discontinued, and patients were instructed to drink water. The analgesic treatment needs, length of hospitalization, drainage, and discharge times were recorded. Results: A total of 43 patients were operated on by the same surgeon. All operations were ended with uniportal video-assisted thoracoscopic surgery. Wedge resection is most commonly indicated for recurrent ipsilateral pneumothorax. Patients walked 345 (range: 150-510) m on the department corridor following bed rest. Paracetamol (2 g) and dexketoprofen (100 mg) were intravenously administered as postoperative analgesia to 76.7% of patients. Narcotic drugs were not needed. Conclusions: Mobilization was recommended in the first hour following uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax.

show abstract

Section: Discussionmentioning

confidence: 99%

Outcomes of mobilization in the first hour following uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax

Unaldi

2024

kitp

View full text Add to dashboard Cite

show abstract

“…We can also reduce unnecessary utilization of anesthetic agents. Other studies have shown that ERAS in thoracic surgery can significantly reduce the readmission rate [ 19 ]. Additionally, given the frequent occurrence of VATS procedures, the implementation of ERAS protocols can effectively reduce preoperative waiting periods and enhance the turnover rate of operating rooms.…”

Section: Discussionmentioning

confidence: 99%

“…Concurrently, Remifentanil, an ultra-short-acting opioid analgesic, targets mu-opioid receptors, mitigating pain perception. Propofol and Remifentanil, when used in combination, have demonstrated a synergistic impact in enhancing anesthesia effectiveness; Propofol reduces Remifentanil dosage requirements during anesthesia to achieve synergistic inhibition of reactions to procedures such as laryngoscopy, intubation, and surgical incitements [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. In addition, Remifentanil synergistically decreases the dosage requirement of Propofol to achieve anesthesia, which is associated with the return to consciousness.…”

Section: Discussionmentioning

confidence: 99%

Logistic Regression Is Non-Inferior to the Response Surface Model in Patient Response Prediction of Video-Assisted Thoracoscopic Surgery

Huang,

Lin,

Wang

et al. 2024

Pharmaceuticals

View full text Add to dashboard Cite

Response surface models (RSMs) are a new trend in modern anesthesia. RSMs have demonstrated significant applicability in the field of anesthesia. However, the comparative analysis between RSMs and logistic regression (LR) in different surgeries remains relatively limited in the current literature. We hypothesized that using a total intravenous anesthesia (TIVA) technique with the response surface model (RSM) and logistic regression (LR) would predict the emergence from anesthesia in patients undergoing video-assisted thoracotomy surgery (VATS). This study aimed to prove that LR, like the RSM, can be used to improve patient safety and achieve enhanced recovery after surgery (ERAS). This was a prospective, observational study with data reanalysis. Twenty-nine patients (American Society of Anesthesiologists (ASA) class II and III) who underwent VATS for elective pulmonary or mediastinal surgery under TIVA were enrolled. We monitored the emergence from anesthesia, and the precise time point of regained response (RR) was noted. The influence of varying concentrations was examined and incorporated into both the RSM and LR. The receiver operating characteristic (ROC) curve area for Greco and LR models was 0.979 (confidence interval: 0.987 to 0.990) and 0.989 (confidence interval: 0.989 to 0.990), respectively. The two models had no significant differences in predicting the probability of regaining response. In conclusion, the LR model was effective and can be applied to patients undergoing VATS or other procedures of similar modalities. Furthermore, the RSM is significantly more sophisticated and has an accuracy similar to that of the LR model; however, the LR model is more accessible. Therefore, the LR model is a simpler tool for predicting arousal in patients undergoing VATS under TIVA with Remifentanil and Propofol.

show abstract

“…There is significant variation in the included observational trials regarding sample size (range of 83 to 10,021 patients), hypothesis (ERAS vs historical control; impact of compliance with ERAS and outcomes), and design (prospective with matched historical controls, entirely retrospective). Of the included 26 observational trials, 21 reported the effect of ERAS on overall complications, with seven studies demonstrating that implementation of an ERAS protocol led to reduced overall post-operative morbidity [3,6,[9][10][11][12]14,15,[18][19][20][21]23,[25][26][27]28,29,[30][31][32]. Five of these studies were comparing the ERAS protocol to historical controls [3,9,10,11,31].…”

Section: Observational Studiesmentioning

confidence: 99%

“…Of the 26 included studies, 14 reported on mortality [12,13,16,18,19,22,23,26,27,29,[30][31][32]. The only study to report a significant difference in mortality was the study by Alwarti et al, a retrospective cohort study published in 2021 [13].…”

Section: Observational Trialsmentioning

confidence: 99%

Does Enhanced Recovery After Surgery Protocols Reduce Complications and Length of Stay After Thoracic Surgery: A Systematic Review of the Literature

Goldblatt,

Bibo,

Crawford

2024

Cureus

View full text Add to dashboard Cite

show abstract

Implementation of an ERAS program in patients undergoing thoracic surgery at a third-level university hospital: an ambispective cohort study

Cited by 3 publications

References 23 publications

Outcomes of mobilization in the first hour following uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax

Outcomes of mobilization in the first hour following uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax

Logistic Regression Is Non-Inferior to the Response Surface Model in Patient Response Prediction of Video-Assisted Thoracoscopic Surgery

Does Enhanced Recovery After Surgery Protocols Reduce Complications and Length of Stay After Thoracic Surgery: A Systematic Review of the Literature

Contact Info

Product

Resources

About