Enhanced Recovery After Surgery in Laparoscopic Surgery

Leissner, Kay B.; Shanahan, Jessica; Bekker, Peter L; Amirfarzan, Houman

doi:10.1089/lap.2017.0239

“…Reducing postoperative pain and accelerating postoperative recovery are the goals of ERAS (Tan, Law, & Gan, 2015). These goals require good pain management.…”

Section: Pain and Erasmentioning

confidence: 99%

Consistency of postoperative pain assessments between nurses and patients undergoing enhanced recovery after gynaecological surgery

Yang

¹

,

Xiong

²

,

Xia

³

et al. 2020

Journal of Clinical Nursing

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Aims and objectives To explore the consistency of pain intensity and pain location assessed by nurses and patients in gynaecology undergoing enhanced recovery after surgery pathway. Background Several studies have shown that clinical nurses' assessment of patients' pain is not always accurate. Little is known about the accuracy of nurses' pain assessments for gynaecological patients. Postoperative pain assessment and management is an essential part of enhanced recovery after surgery. Design Comparative cross‐sectional study. Methods A total of 160 patients were recruited and only 85 patients and 17 nurses participated. Patients and nurses recorded pain scores (using an 11‐point Numeric Rating Scale) and pain location (incision pain, surgical area pain in the abdominal cavity, other pain or no pain) on Pain Assessment Forms at 4 hr after surgery and on the first and second postoperative days. We used the STROBE guidelines to report our study. Results The patients' pain score was higher than that of nurses from 4 hr to second day after laparoscopic surgery at rest. The pain scores of both nurses and patients decreased over this period of time. All the intraclass correlation coefficients were between 0.214–0.296. At the three time points, surgical area pain in the abdominal cavity and abdominal incision pain were the main pain areas. All the kappa coefficients were between 0.164–0.255. Conclusions The consistency of postoperative pain assessment about pain score and pain location between nurses and patients was not high. We should attach importance to systematic pain assessment, and more detailed enhanced recovery after surgery pathways should be developed about pain assessment. Relevance to clinical practice Continuing education for nurses regarding pain assessment is necessary. Nurses should accept the patient's self‐reported pain. There should be a step that gives more time for pain assessment in enhanced recovery after surgery pathways.

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“…Thirdly, the clinical application of ERAS requires active patient cooperation, and adequate communication between doctors and patients. Finally, the use of problem-oriented philosophy may help patients benefit from existing technologies [1,5].…”

Section: Eras Requires More Humanistic Care In Clinical Practicementioning

confidence: 99%

“…One core aim of ERAS is to reduce stress, including physical and psychological stress, in the perioperative period. Therefore, ERAS requires medical staff to optimize clinical techniques and measures (preoperative rehabilitation, optimizing bowel preparation, optimizing anesthesia, multimodal analgesia, rational use of various catheters, early enteral nutrition, getting early out of bed, changing clinical care patterns, controlling gastrointestinal discomfort, intraoperative heat preservation, restriction of fluid input, prevention of antibiotics, strict discharge assessment, and complete post-hospital visit system) [1].…”

Section: Precision Organ Function Protection Promotes Rapid and Long-lasting Recovery Of Patientsmentioning

confidence: 99%

See 1 more Smart Citation

Precision Organ Function Protection for Enhanced Recovery after Surgery

Lu¹,

Xiu-Xiu²,

Wang³

et al. 2019

Transl Perioper & Pain Med

0

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The concept of enhanced recovery after surgery (ERAS) has gained gratifying achievements in clinical practice, but there are still many disputes and incompatibilities in its application. The reasons for this phenomenon are multifaceted, is evident at multilevels and needs further exploration and improvement.By combining previous studies and our clinical experience, we propose an enhanced concept of ERAS, i.e., precision organ function protection (POFP) for ERAS to promote lasting rehabilitation of patients after surgery. We prefer to use "important organ function outcomes" (IOFOs) as the clinical target of ERAS. Perioperative optimal organ function preservation by using a series of techniques can help patients recover quickly and return to baseline function as soon as possible. This concept has greatly expanded the connotation of the traditional ERAS, whose core idea was reducing stress, providing analgesia and humane care.

show abstract

“…Thirdly, the clinical application of ERAS requires active patient cooperation, and adequate communication between doctors and patients. Finally, the use of problem-oriented philosophy may help patients benefit from existing technologies [1,5].…”

Section: Eras Requires More Humanistic Care In Clinical Practicementioning

confidence: 99%

Untitled

2017

Transl Perioper & Pain Med

0

View full text Add to dashboard Cite

The concept of enhanced recovery after surgery (ERAS) has gained gratifying achievements in clinical practice, but there are still many disputes and incompatibilities in its application. The reasons for this phenomenon are multifaceted, is evident at multilevels and needs further exploration and improvement.By combining previous studies and our clinical experience, we propose an enhanced concept of ERAS, i.e., precision organ function protection (POFP) for ERAS to promote lasting rehabilitation of patients after surgery. We prefer to use "important organ function outcomes" (IOFOs) as the clinical target of ERAS. Perioperative optimal organ function preservation by using a series of techniques can help patients recover quickly and return to baseline function as soon as possible. This concept has greatly expanded the connotation of the traditional ERAS, whose core idea was reducing stress, providing analgesia and humane care.

show abstract

Enhanced Recovery After Surgery in Laparoscopic Surgery

Cited by 23 publications

References 101 publications

Consistency of postoperative pain assessments between nurses and patients undergoing enhanced recovery after gynaecological surgery

Consistency of postoperative pain assessments between nurses and patients undergoing enhanced recovery after gynaecological surgery

Precision Organ Function Protection for Enhanced Recovery after Surgery

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