Enhanced recovery programme reduces opiate consumption in hip hemiarthroplasty

Talboys, Rupert; Mak, Mandy; Modi, Nitin; Fanous, Nabil; Cutts, Steven

doi:10.1007/s00590-015-1722-2

Cited by 27 publications

(24 citation statements)

References 17 publications

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“…Statistical heterogeneity was found among studies (I 2 =98%, p<0.01), and a random effect model was used. One study reported by Talboys 14 indicated that there was no statistical difference in LOS between the two groups, yet despite this, the overall meta-analysis showed that ERAS significantly shortened LOS. The difference was statistically significant for comparison between the ERAS and control groups (SMD=−0.85, 95% CI=−1.24 to −0.45, p=0.01) ( figure 2a ).…”

Section: Resultsmentioning

confidence: 90%

Enhanced recovery after surgery for hip and knee arthroplasty: a systematic review and meta-analysis

Zhu

Qian

Jiang

et al. 2017

Postgraduate Medical Journal

230

177

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ObjectivesTo collect data of randomised controlled trials (RCTs) and clinical controlled trials (CCTs) for evaluating the effects of enhanced recovery after surgery on postoperative recovery of patients who received total hip arthroplasty (THA) or total knee arthroplasty (TKA).MethodsRelevant, published studies were identified using the following key words: arthroplasty, joint replacement, enhanced recovery after surgery, fast track surgery, multi-mode analgesia, diet management, or steroid hormones. The following databases were used to identify the literature consisting of RCTs or CCTs with a date of search of 31 December 2016: PubMed, Cochrane, Web of knowledge, Ovid SpringerLink and EMBASE. All relevant data were collected from studies meeting the inclusion criteria. The outcome variables were postoperative length of stay (LOS), 30-day readmission rate, and total incidence of complications. RevMan5.2. software was adopted for the meta-analysis.ResultsA total of 10 published studies (9936 cases) met the inclusion criteria. The cumulative data included 4205 cases receiving enhanced recovery after surgery (ERAS), and 5731 cases receiving traditional recovery after surgery (non-ERAS). The meta-analysis showed that LOS was significantly lower in the ERAS group than in the control group (non-ERAS group) (p<0.01), and there were fewer incidences of complications in the ERAS group than in the control group (p=0.03). However, no significant difference was found in the 30-day readmission rate (p=0.18).ConclusionsERAS significantly reduces LOS and incidence of complications in patients who have had THA or TKA. However, ERAS does not appear to significantly impact 30-day readmission rates.

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Section: Resultsmentioning

confidence: 90%

Enhanced recovery after surgery for hip and knee arthroplasty: a systematic review and meta-analysis

Zhu

Qian

Jiang

et al. 2017

Postgraduate Medical Journal

230

177

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“…ERAS protocol has been widely applied in many surgical fields, especially in abdominal surgery. In the past few years, there were reports on its application in orthopaedic surgery such as joint replacement, trauma and spine surgery [21][22][23]. However, the literature on pediatric orthopaedic surgery was quite rare.…”

Section: Discussionmentioning

confidence: 99%

Enhanced recovery care versus traditional non-ERAS care following osteotomies in developmental dysplasia of the hip in children: a retrospective case-cohort study

Rai

et al. 2020

BMC Musculoskelet Disord

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Background: Enhanced recovery after surgery (ERAS) has been shown to shorten the length of hospital stay and reduce the incidence of perioperative complications in many surgical fields. However, there has been a paucity of research examining the application of ERAS in major pediatric orthopaedic surgeries. This study aims to compare the perioperative complications and length of hospital stay after osteotomies in children with developmental dysplasia of the hip (DDH) between ERAS and traditional non-ERAS group. Methods: The ERAS group consisted of 86 patients included in the ERAS program from January 2016 to December 2017. The Control group consisted of 82 DDH patients who received osteotomies from January 2014 to December 2015. Length of hospital stay, physiological function, postoperative visual analogue scale (VAS) score, and postoperative complications were compared between the two groups. Results: The mean duration of hospital stay was significantly reduced from 10.0 ± 3.1 in the traditional care group to 6.0 ± 0.8 days in the ERAS(P < 0.001). The average VAS score in the first 3 days was significantly lower in the ERAS group (2.9 ± 0.8) than the traditional non-ERAS group (4.0 ± 0.8) (P < 0.001). However, there was no significant difference in the frequency of break-out pain (VAS > 4) between two groups (29.5 ± 6.3 times vs.30.6 ± 6.5 times, P = 0.276). The frequency of postoperative fever was lower in the ERAS group. The frequency of urinary tract infection in both groups were not noticeable because the catheter was removed promptly after the surgery. Conclusion: The ERAS protocol is both safe and feasible for pediatric DDH patients undergoing osteotomies, and it can shorten the length of hospital stay without increasing the risk of perioperative complications.

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“…ERAS protocol has been widely applied in many surgical fields, especially in abdominal surgery. In the past few years, there were reports on its application in orthopedic surgery such as joint replacement, trauma and spine surgery [17,18,19]. However, the literature on pediatric orthopedic surgery was quite rare.…”

Section: Discussionmentioning

confidence: 99%

Enhanced recovery care versus traditional non- ERAS care following osteotomies in developmental dysplasia of the hip in children : a retrospective case-cohort study

Rai

et al. 2020

Preprint

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KEYWORDSenhanced recovery after surgery, developmental dysplasia of the hip, complications, hospitalization, osteotomy 2 Abstract Background: Enhanced recovery after surgery (ERAS) has been shown to shorten the length of hospital stay and reduce the incidence of perioperative complications in many surgical fields.However, there has been a paucity of research examining the application of ERAS in major pediatric orthopedic surgeries. This study aims to compare the perioperative complications and length of hospital stay after osteotomies in children with developmental dysplasia of the hip (DDH) between ERAS and traditional non-ERAS group.Methods: The ERAS group consisted of 86 patients included in the ERAS program from . Length of hospital stay, physiological function, postoperative visual analogue scale (VAS) score, and postoperative complications were compared between the two groups.Results: The mean duration of hospital stay was significantly reduced from 10.0±3.1 in the traditional care group to 6.0±0.8 days in the ERAS(P<0.001). The VAS score in 3-day was significantly lower in ERAS group (2.9±0.8) than traditional non-ERAS group (4.0±0.8) (P<0.001). However, there was no significant difference in the frequency of breakout pain (VAS >4) between two groups (29.5±6.3 vs.30.6±6.5, P=0.276). The frequency of postoperative fever was lower in the ERAS group. The frequency of urinary tract infection in both groups were not noticeable because the catheter was removed promptly after the surgery.Conclusion: The ERAS protocol is both safe and feasible for pediatric DDH patients undergoing osteotomies, and it can shorten the length of hospital stay without increasing the risk of perioperative complications.

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Enhanced recovery programme reduces opiate consumption in hip hemiarthroplasty

Abstract: The ERP reduces post-operative oral opiates and PCA requirements in fractured NOF cases and by inference reduces pain. It does not appear to affect length of hospital stay in an acute unit.

Cited by 27 publications

References 17 publications

Enhanced recovery after surgery for hip and knee arthroplasty: a systematic review and meta-analysis

Enhanced recovery after surgery for hip and knee arthroplasty: a systematic review and meta-analysis

Enhanced recovery care versus traditional non-ERAS care following osteotomies in developmental dysplasia of the hip in children: a retrospective case-cohort study

Enhanced recovery care versus traditional non- ERAS care following osteotomies in developmental dysplasia of the hip in children : a retrospective case-cohort study

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