Enhanced Recovery after Surgery (ERAS) vs Conventional Perioperative Care for Major Gynecologic Surgery in Pakistan
DOI:
https://doi.org/10.70749/ijbr.v3i6.2099Keywords:
ERAS, gynecologic surgery, recovery, pain management, hospital stayAbstract
Objective: To evaluate the effectiveness of Enhanced Recovery after Surgery (ERAS) protocols in comparison to conventional perioperative care for major gynecologic surgery at Hayatabad Medical Complex, Peshawar, Pakistan. The primary objective was to assess differences in postoperative recovery, pain levels, and hospital stay duration between the two groups. Methodology: A retrospective analysis was conducted from June 2024 to December 2024, involving 150 patients who underwent major gynecologic surgeries, divided into two groups: ERAS (75 patients) and conventional care (75 patients). Data on patient demographics, length of stay, pain scores, recovery time, and comorbidities were collected and analyzed using statistical tests, including independent t-tests. Results: The ERAS group showed a significant reduction in length of stay, with a mean of 5.1 days compared to 8.3 days in the conventional care group (p = 0.01). Pain scores were also significantly lower in the ERAS group (4.2 vs. 6.5, p = 0.02). Recovery time was shorter in the ERAS group (12.3 days) compared to the conventional care group (17.5 days, p = 0.04). The complication rates were 8% in the ERAS group and 10% in the conventional care group, with no significant difference. Conclusion: ERAS protocols significantly improve postoperative outcomes in major gynecologic surgery by reducing hospital stays, pain, and recovery times. The results support the feasibility of implementing ERAS protocols in Pakistan, offering an effective model for optimizing surgical care in resource-limited settings.
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References
1. Filho ALS, Santiago A, Derchain S, Carvalho J. enhanced recovery after surgery (eras): new concepts in the perioperative management of gynecologic surgery. RBGO Gynecol Obstet 2018;40:433–6.
https://doi.org/10.1055/s-0038-1668581.
2. Nelson G, Bakkum-Gamez J, Kalogera E, Glaser G, Altman A, Meyer LA, et al. guidelines for perioperative care in gynecologic/oncology: enhanced recovery after surgery (eras) society recommendations—2019 update. Int J Gynecol Cancer 2019;29:651–68.
https://doi.org/10.1136/ijgc-2019-000356.
3. Miralpeix E, Nick AM, Meyer LA, Cata J, Lasala J, Mena GE, et al. a call for new standard of care in perioperative gynecologic oncology practice: impact of enhanced recovery after surgery (eras) programs. Gynecol Oncol 2016;141:371–8. https://doi.org/10.1016/j.ygyno.2016.02.019.
4. Brown M, Simpson V, Clark A, Matossian M, Holman S, Jernigan A, et al. eras implementation in an urban patient population undergoing gynecologic surgery. Best Pract Res Clin Obstet Gynaecol 2022.
https://doi.org/10.1016/j.bpobgyn.2022.07.009.
5. Miglani U, Taneja D, Laul P. 2022-ra-1523-esgo to study the impact of implementation of enhanced recovery after surgery (eras) protocol on perioperative outcomes in gynecology oncology surgery patients. Miscellaneous 2022. https://doi.org/10.1136/ijgc-2022-esgo.459.
6. Gupta S, Rane A, Vengavati V, Achari M, Mubeen A, Gupta U. long-term experience with a modified eras protocol for urogynaecology day procedures. J Obstet Gynaecol (Lahore) 2021;42:1415–8.
https://doi.org/10.1080/01443615.2021.1983784.
7. Yilmaz G, Akca A, Kiyak H, Salihoglu Z. comparison of enhanced recovery protocol with conventional care in patients undergoing minor gynecologic surgery. Videosurgery Other Miniinvasive Tech 2019:220–6.
https://doi.org/10.5114/wiitm.2019.85464.
8. Goswami B, Jaketiya B, Patel M, Gupta A. comparative study of eras protocol with conventional protocol for gynecological surgery. PARIPEX INDIAN J Res 2022.
https://doi.org/10.36106/paripex/5900876.
9. Ahmad S. is pakistan ready for “enhanced recovery after surgery” (eras)? 2017;21:4–5.
10. Kim W-J, Noh JJ, Bang Y-J, Yang M-Y, Kim J-H, Park C-H, et al. initial experience with the enhanced recovery after surgery (eras) protocols in gynecologic surgery at an urban academic tertiary medical center. Gland Surg 2024;13:19–31.
https://doi.org/10.21037/gs-23-249.
11. Bisch S, Wells T, Gramlich L, Faris P, Wang X, Tran D, et al. enhanced recovery after surgery (eras) in gynecologic oncology: system-wide implementation and audit leads to improved value and patient outcomes. Gynecol Oncol 2018;151 1:117–23.
https://doi.org/10.1016/j.ygyno.2018.08.007.
12. Rauf F, Rauf S, Sannan A, Hanif M. ftp4.8 a survey on enhanced recovery after surgery (eras) in pakistan. Br J Surg 2023.
https://doi.org/10.1093/bjs/znad241.371.
13. Soomro F, Razzaq A, Qaisar R, Ansar M, Kazmi T. enhanced recovery after surgery: are benefits demonstrated in international studies replicable in pakistan?. Cureus 2021;13.
https://doi.org/10.7759/cureus.19624.
14. McDonnell J, Conti AA, Gibbons D, Ahern D, Butler J. is the adoption of eras protocols into spinal surgery inevitable?. Clin Spine Surg 2019.
https://doi.org/10.1097/BSD.0000000000000900.
15. [15] Singh R, Gupta A, Gupta N, Kumar V. enhanced recovery after surgery (eras): are anaesthesiologists prepared for the paradigm shift in perioperative care? a prospective cross-sectional survey in india. Indian J Anaesth 2021;65.
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