The Evolution of Surgical Enhanced Recovery Pathways: a Review

Elhassan, Amir; Ahmed, Ahmed; Awad, Hamdy; Humeidan, Michelle; Nguyen, Viet; Cornett, Elyse M.; Urman, Richard D.; Kaye, Alan D.

doi:10.1007/s11916-018-0727-z

Cited by 17 publications

(12 citation statements)

References 51 publications

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“…Surgery will be carried out in a controlled theatre facility including the use of recommended theatre ventilation system, correct donning and doffing of theatre scrubs, use of regional anaesthesia to minimise AGP including the operative procedure (Iyengar et al 2020c, Raghavan et al 2020). The patient recovery process will have to be streamlined with effective use of an enhanced recovery pathway for rehabilitation after surgery to provide safe and efficient postoperative care (Elhassan et al 2018).…”

Section: Infection Prevention and Controlmentioning

confidence: 99%

“…Enhanced recovery pathways are well-defined perioperative health care programmes utilising evidence-based interventions designed to standardise techniques including physiotherapy protocols to facilitate early discharge from hospitals after surgery. They are commonly used across many NHS trusts in the UK and have been shown to reduce length of in-hospital stay, overall costs and improve patient experience (Elhassan et al 2018, Thomas et al 2008).…”

Section: Rehabilitation Carementioning

confidence: 99%

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Planning and analysing ‘Green’ post-COVID-19 orthopaedic perioperative recovery pathway

Iyengar

Jain

Kariya

2021

Journal of Perioperative Practice

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The effect of the severe acute respiratory syndrome coronavirus 2 pandemic on the National Health Service in the United Kingdom has been profound and unprecedented with suspension of most elective surgeries. As we are emerging from lockdown now, restarting elective surgical procedures in a safe and effective manner is an expected challenge. Many perioperative factors including patient prioritisation, risk assessment, health infrastructure and infection prevention strategies need to be considered for patient safety. The British Orthopaedic Association, along with the National Health Service, have provided recent guidelines for restarting non-urgent and orthopaedic care in the United Kingdom. In this article we review the current guidelines and literature to provide some clarity for clinical practice.

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Section: Infection Prevention and Controlmentioning

confidence: 99%

Section: Rehabilitation Carementioning

confidence: 99%

Planning and analysing ‘Green’ post-COVID-19 orthopaedic perioperative recovery pathway

Iyengar

Jain

Kariya

2021

Journal of Perioperative Practice

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“…Mediante la utilización de una combinación de analgesia regional, ingesta oral y deambulación posoperatoria temprana demostraron una reducción en la estancia hospitalaria de diez a dos días. 5,6 Desde la creación en el 2010 de la sociedad ERAS se han realizado varias publicaciones con recomendaciones específicas para diferentes procedimientos quir urgicos. 7 Desde hace algunos años la atención en la adaptación de estrategias ERAS se ha centrado en la población pediátrica.…”

Section: Evolución Históricaunclassified

Enhancing recovery in pediatric major abdominal surgery

Trujillo-Mejía

Zapata-Contreras

Melo-Aguilar

et al. 2020

Colombian Journal of Anesthesiology

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Introducción: Los programas de recuperación intensificada después de cirugía (ERAS, por sus siglas del inglés enhanced recovery after surgery) en adultos han impactado positivamente en morbilidad, mortalidad y costos en salud. Es conocido su efecto respecto a su efectividad en población pediátrica.Objetivo: Elaborar una revisión narrativa respecto a la evidencia actual de las diferentes estrategias en el marco de programas de recuperación intensificada en cirugía pediátrica (ERPS, por sus siglas del inglés enhancing recovery in pediatric surgery), en el contexto de cirugía abdominal mayor. Métodos: Se realizó una b usqueda sobre la evidencia científica disponible en bases de datos (Pubmed/Medline, Science Direct, OVID, SciELO) para elaborar una revisión narrativa de la literatura.Conclusiones: Aunque existe evidencia limitada sobre la utilidad de los protocolos ERAS en la población pediátrica sometida a cirugía abdominal mayor, podrían lograrse mejores resultados si se adoptan estas estrategias en pacientes pediátricos.

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“…A number of studies demonstrated how significant improvements in effectiveness and efficiency may not follow from the introduction of a single clinical innovation in the treatment (be it surgical, medical or rehabilitative), but from the way in which the single procedures are related [ 6 – 9 ]. This is the core idea of multidisciplinary accelerated pathways like Fast-Track or Enhanced Recovery After Surgery (ERAS), whose value is maximized by the cooperation between clinical professionals (who offer their expertise on the field) and researchers (who look for best practices and innovations in scientific literature) [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Introducing enhanced recovery after surgery in a high-volume orthopaedic hospital: a health technology assessment

Vanni

Foglia

Pennestrì

et al. 2020

BMC Health Serv Res

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Background: The number of patients undergoing joint arthroplasty is increasing worldwide. An Enhanced Recovery After Surgery (ERAS) pathway for hip and knee arthroplasty was introduced in an Italian high-volume research hospital in March 2018. Methods: The aim of this mixed methods observational study is to perform a health technology assessment (HTA) of the ERAS pathway, considering 938 procedures performed after its implementation, by means of a hospitalbased approach derived from the EUnetHTA (European Network for Health Technology Assessment) Core Model. The assessment process is based on dimensions of general relevance, safety, efficacy, effectiveness, economic and financial impact, equity, legal aspects, social and ethical impact, and organizational impact. A narrative review of the literature helped to identify general relevance, safety and efficacy factors, and a set of relevant sub-dimensions submitted to the evaluation of the professionals who use the technology through a 7-item Likert Scale. The economic and financial impact of the ERAS pathway on the hospital budget was supported by quantitative data collected from internal or national registries, employing economic modelling strategies to identify the amount of resources required to implement it. Results: The relevance of technology under assessment is recognized worldwide. A number of studies show accelerated pathways to dominate conventional approaches on pain reduction, functional recovery, prevention of complications, improvements in tolerability and quality of life, including fragile or vulnerable patients. Qualitative surveys on clinical and functional outcomes confirm most of these benefits. The ERAS pathway is associated with a reduced length of stay in comparison with the Italian hospitalization average for the same procedures, despite the poor spread of the pathway within the country may generate postcode inequalities. The economic analyses show how the resources invested in training activities are largely depreciated by benefits once the technology is permanently introduced, which may generate hospital cost savings of up to 2054,123.44 € per year. Conclusions: Galeazzi Hospital's ERAS pathway for hip and knee arthroplasty results preferable to traditional approaches following most of the HTA dimensions, and offers room for further improvement. The more comparable practices are shared, the before this potential improvement can be identified and addressed.

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The Evolution of Surgical Enhanced Recovery Pathways: a Review

Cited by 17 publications

References 51 publications

Planning and analysing ‘Green’ post-COVID-19 orthopaedic perioperative recovery pathway

Planning and analysing ‘Green’ post-COVID-19 orthopaedic perioperative recovery pathway

Enhancing recovery in pediatric major abdominal surgery

Introducing enhanced recovery after surgery in a high-volume orthopaedic hospital: a health technology assessment

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