Perioperative management in gynecological surgery based on the ERAS program

Effectiveness of an Educational Intervention with Guidelines from the Total Acceleration of Postoperative Recovery Project (ACERTO) in Gynecology

“…On the other hand, the efforts to adapt the main recommendations such as abbreviation of preoperative fasting, prophylaxis of VTE, and stimulation of multimodal, as occurred with the ACERTO project, are commendable initiatives to bring evidence-based medicine from practice. [1][2][3][4][5][6][7]10 In addition to projects adapted to the local reality, efforts to produce scientific discussions, training courses or educational interventions, such as the methodology used in this study, can be effective in disseminating knowledge and adherence to medical approaches such as paradigm shifts. The process of changing behavior occurs progressively with individual response; however, education provides the basis for the security of the practical application of new technologies.…”

“…Derived from the solid foundations of the Enhanced Recovery After Surgery (ERAS), the ACERTO project, in Brazil and other Latin American countries, prioritizes evidence-based medicine in addition to being an educational program. [1][2][3] Currently, several medical societies, including the International Federation of Gynecology and Obstetrics (FIGO), 4 American College of Obstetricians and Gynecologists (ACOG), 5 the European Society for Clinical Nutrition and Metabolism (ESPEN), 6 and the Brazilian Federation of Gynecology and Obstetrics (FEBRASGO), 7 among others, are engaged in the development of clinical guidelines and protocols that improve the quality of perioperative care through ERAS. Mastery of the surgical technique is important; however, perioperative care favors positive surgical results, in addition to maximizing recovery, minimizing unpleasant symptoms such as pain, reducing complications such as thrombosis, and decreasing hospitalization time and hospital costs.…”

“…Mastery of the surgical technique is important; however, perioperative care favors positive surgical results, in addition to maximizing recovery, minimizing unpleasant symptoms such as pain, reducing complications such as thrombosis, and decreasing hospitalization time and hospital costs. [1][2][3][4][5][6][7] The term ACERTO was an acronym developed in Latin America for ERAS with the purpose of favoring the understanding and adherence of the ERAS recommendations with local adaptations. 1 The ACERTO project, just like ERAS guide-lines, focuses on clear information to the patient about the surgery, abbreviation of preoperative fasting, early postsurgical patient ambulation, thrombosis prophylaxis, early oral refeeding, optimization of the use of drains and probes to avoid unnecessary use, hyperhydration prevention, and facilitatation of analgesia to stimulate the recovery of patients undergoing surgical treatment.…”

“…1 The ACERTO project, just like ERAS guide-lines, focuses on clear information to the patient about the surgery, abbreviation of preoperative fasting, early postsurgical patient ambulation, thrombosis prophylaxis, early oral refeeding, optimization of the use of drains and probes to avoid unnecessary use, hyperhydration prevention, and facilitatation of analgesia to stimulate the recovery of patients undergoing surgical treatment. [1][2][3][4][5][6][7] Despite the scientific support of the ACERTO Project's recommendations, few hospitals or services apply its guidelines in practice due to lack of knowledge and adherence of health professionals. Given this scenario, the objective of the present study was to evaluate the effectiveness of an educational intervention in the gynecology department of a university hospital on the main recommendations of the ACERTO project to foster the knowledge and adherence of professionals in the practical applicability of standardized measures, such as the abbreviation of the preoperative fasting, prophylaxis for thromboembolic events, and multimodal and humanized analgesia approach to enable postoperative recovery in gynecological surgeries.…”

“…Mastery of the surgical technique is important; however, perioperative care favors positive surgical results, in addition to maximizing recovery, minimizing unpleasant symptoms such as pain, reducing complications such as thrombosis, and decreasing hospitalization time and hospital costs. 1 2 3 4 5 6 7 …”