Enhanced recovery after surgery in children

Abstract

Enhanced recovery after surgery (ERAS) is a systematic approach to optimize a patient's health and improve clinical outcomes, increase patient satisfaction and decrease healthcare costs. Enhanced recovery protocols have been used across a variety of surgical disciplines and patient groups to improve patient safety and reduce hospital length of stay without increasing return visits to the system. ERAS involves the application of clinical decision making throughout the patient experience with interventions in the preoperative, perioperative and post operative phases. In addition, ERAS is multidisciplinary and the success of an ERAS program is dependent on the effort and integration of stakeholders across the healthcare system.Utilization of ERAS systems have grown across the global adult surgical community over the last three decades and adoption in pediatric surgery has only occurred recently. Hospitals in both adult and pediatric surgery have found that implementation of ERAS systems lead to a shortened length of stay and reduced complications without increasing patient returns to the system. Importantly patients who have surgery within an ERAS program experience less pain, less opioid utilization, a quicker recovery and increased satisfaction.In pediatric surgery ERAS has successfully been employed across most all disciplines from congenital cardiac surgery to colorectal surgery. The evolution of ERAS continues as a paradigm of quality and safety.

Efficacy analysis of enhanced recovery after surgery in laparoscopic-assisted radical resection of type I choledochal cyst

“…ERAS runs through preoperative, intraoperative and postoperative aspects [4] : 1. Detailed preoperative education and perfect preoperative preparation, 2.…”

Pain Control and Opioid Consumption Following Laparoscopic Appendectomy with the Use of Quadratus Lumborum Regional Anesthesia

“…Perioperative adjunct analgesic strategies to minimize opioid consumption have been a major focus in the pediatric literature [1,2]. Enhanced recovery after surgery (ERAS) protocols offer a systematic approach to optimizing outcomes and are becoming more frequently adopted in children's surgery pathways [3]. Multimodal opioid-sparing pain regimens function as a primary component of these ERAS protocols and include acetaminophen, non-steroidal anti-in ammatory drugs (NSAIDs), and gabapentin [3].…”

“…Enhanced recovery after surgery (ERAS) protocols offer a systematic approach to optimizing outcomes and are becoming more frequently adopted in children's surgery pathways [3]. Multimodal opioid-sparing pain regimens function as a primary component of these ERAS protocols and include acetaminophen, non-steroidal anti-in ammatory drugs (NSAIDs), and gabapentin [3]. Neuraxial and regional anesthetics perioperatively function as an extension of these protocols to reduce rates of postoperative nausea and vomiting and uncontrolled pain [3].…”

“…Multimodal opioid-sparing pain regimens function as a primary component of these ERAS protocols and include acetaminophen, non-steroidal anti-in ammatory drugs (NSAIDs), and gabapentin [3]. Neuraxial and regional anesthetics perioperatively function as an extension of these protocols to reduce rates of postoperative nausea and vomiting and uncontrolled pain [3]. However, data are currently limited in pediatric patients regarding the effectiveness of protocolization of regional anesthetic utilization.…”

Enhanced Recovery Care versus Traditional Care after Surgery in Pediatric Patients with Inflammatory Bowel Disease: A Retrospective Case-Control Study

“…Perioperative management traditionally included prolonged fasting and bed rest, bowel preparation, drainage tube and catheter insertion, and opioid-based analgesia. The evidence-based, patient-centered, multidisciplinary ERAS program is based on preoperative counseling, optimal anesthesia, a minimally invasive surgical approach, a shortened fasting period, early mobilization, and the nonroutine use of surgical drains [ 7 , 8 ]. ERAS was first used in adult colorectal surgery and then spread to other surgical specialties [ 7 , 9 ].…”