Spanish survey on enhanced recovery after surgery

Ripollés‐Melchor, Javier; Francés, R. Casans; Abad‐Gurumeta, Alfredo; Suárez-de-la-Rica, Alejandro; Ramírez-Rodríguez, José Manuel; López‐Timoneda, F.; Calvo-Vecino, J.M.

doi:10.1016/j.redare.2016.02.002

Cited by 14 publications

(13 citation statements)

References 30 publications

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“…Although ERAS remains a popular practice internationally, compliance of some elements is still somewhat limited. A recent survey of Spanish anesthesiologists and surgeons described that the majority applied early feeding and mobilization and goal‐directed fluids practices, but only half utilized preoperative carbohydrate loading …”

Section: Limitations and Future Considerationsmentioning

confidence: 99%

“…A recent survey of Spanish anesthesiologists and surgeons described that the majority applied early feeding and mobilization and goal-directed fluids practices, but only half utilized preoperative carbohydrate loading. 53 Preoperative carbohydrate loading continues to be one of the main tenets of enhanced recovery pathways. Surgical stress is minimized and surgical outcomes are optimized when carbohydrate loading is incorporated in a patient's preoperative preparation.…”

Section: Limitations and Future Considerationsmentioning

confidence: 99%

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How Sweet Is This? A Review and Evaluation of Preoperative Carbohydrate Loading in the Enhanced Recovery After Surgery Model

et al. 2019

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Preoperative carbohydrate loading is a contemporary element of the enhanced recovery after surgery (ERAS) paradigm. In addition to intraoperative surgical and anesthetic modifications and postoperative care practices, preoperative optimization is essential to good postsurgical outcomes. What was long held as dogma, a period of prolonged fasting prior to the administration of anesthesia, was later re‐examined and challenged. Along with the proposed physiologic effects of decreasing the surgical stress response and insulin resistance, preoperative carbohydrate loading was also demonstrated to improve patient satisfaction and well‐being, without an increase in perioperative complications. The benefits are most strongly observed in abdominal and cardiac surgery patients, but there has also been data which support its use in other specialties and surgeries. Barriers to the adoption of perioperative carbohydrate loading are few, but importantly include overcoming the inertia to modify older and more restrictive fasting guidelines and achieving the multidisciplinary consensus necessary to implement such changes. Despite these challenges, and with an existing body of evidence supporting its benefits, preoperative carbohydrate loading presents a significant contribution to the ERAS programs.

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Section: Limitations and Future Considerationsmentioning

confidence: 99%

Section: Limitations and Future Considerationsmentioning

confidence: 99%

How Sweet Is This? A Review and Evaluation of Preoperative Carbohydrate Loading in the Enhanced Recovery After Surgery Model

et al. 2019

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“…Previous surveys [ 6 , 7 , 8 ] investigating the spontaneous diffusion of the ERAS protocol have demonstrated a low adoption of several items among both surgeons and anesthesiologists, showing a substantial variation in perioperative practice all around the world. A recent Canadian study [ 9 ] has shown that a formalized ERAS protocol significantly increases the rates of compliance to intra and postoperative items, such as early diet advancement on postoperative day 0, restrictive use of intravenous fluids, and early catheter and drainage removal.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Care in Colorectal Cancer Surgery before a Structured Implementation Program of the ERAS Protocol in a Regional Network. The Piemonte EASY-NET Project

et al. 2021

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Background: In 2019, the Enhanced Recovery After Surgery (ERAS) protocol for colorectal cancer surgery was adopted by a minority of hospitals in Piemonte (4.3 million inhabitants, north-west Italy). The present analysis aims to compare the level of application of the ERAS protocol between hospitals already adopting it (ERAS, N = 3) with the rest of the regional hospitals (non-ERAS, N = 28) and to identify possible obstacles to its application. Methods: All patients surgically treated for a newly diagnosed colorectal cancer during September–November 2019, representing the baseline period of a randomized controlled trial with a cluster stepped-wedge design, were included. Indicators of compliance to the ERAS items were calculated overall and for groups of items (preoperative, intraoperative and postoperative) and analyzed with a multilevel linear model adjusting for patients’ characteristics, considering centers as random effects. Results: Overall, the average level of compliance to the ERAS protocol was 56% among non-ERAS centers (N = 364 patients) and 80% among ERAS ones (N = 79), with a difference of 24% (95% CI: −41.4; −7.3, p = 0.0053). For both groups of centers, the lowest level of compliance was recorded for postoperative items (42% and 66%). Sex, age, presence of comorbidities and American Society of Anesthesiologists (ASA) score were not associated with a different probability of compliance to the ERAS protocol. Conclusions: Several items of the ERAS protocol were poorly adopted in colorectal surgery units in the Piemonte region in the baseline period of the ERAS Colon-Rectum Piemonte study and in the ERAS group. No relevant obstacles to the ERAS protocol implementation were identified at patient level.

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“…A similar survey among surgeons and anaesthesiologists in Spain reported that 86.1 percent of respondents were familiar with ERAS pathways, which is similar to our survey results. [ 9 ] A survey among Indian gastroenterology surgeons to assess their views on fast-track surgery received a very poor response, and four of 18 respondents of the survey had never heard about ERAS. [ 10 ]…”

Section: Discussionmentioning

confidence: 99%

“…Ripollés-Melchor et al . [ 9 ] reported the use of preoperative oral complex carbohydrates by 51.4% of the respondents in their survey. The poor implementation of this arm of ERAS can be related to the ubiquitous fear of aspiration in the mind of anaesthesiologists or the lack of awareness of its benefits or institutional policies in this regard.…”

Section: Discussionmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS): Are anaesthesiologists prepared for the paradigm shift in perioperative care? A prospective cross-sectional survey in India

Gupta

Singh

Gupta

et al. 2021

Indian Journal of Anaesthesia

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Spanish survey on enhanced recovery after surgery

Cited by 14 publications

References 30 publications

How Sweet Is This? A Review and Evaluation of Preoperative Carbohydrate Loading in the Enhanced Recovery After Surgery Model

How Sweet Is This? A Review and Evaluation of Preoperative Carbohydrate Loading in the Enhanced Recovery After Surgery Model

Perioperative Care in Colorectal Cancer Surgery before a Structured Implementation Program of the ERAS Protocol in a Regional Network. The Piemonte EASY-NET Project

Enhanced recovery after surgery (ERAS): Are anaesthesiologists prepared for the paradigm shift in perioperative care? A prospective cross-sectional survey in India

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