Randomized Controlled Trial Comparing the Outcomes of Enhanced Recovery After Surgery and Standard Recovery Pathways in
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ORIGINAL CONTRIBUTIONS
Randomized Controlled Trial Comparing the Outcomes of Enhanced Recovery After Surgery and Standard Recovery Pathways in Laparoscopic Sleeve Gastrectomy S. Prabhakaran 1 & Shivanshu Misra 1 & M. Magila 1 & S. Saravana Kumar 1 & Sudarsan Kasthuri 1 & Chinnusamy Palanivelu 1 & P. Praveen Raj 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose The enhanced recovery after surgery (ERAS) pathway is an evidence-based perioperative pathway that results in less pain, earlier recovery, and lower complication rates. Studies to prove their efficacy over standard recovery pathways in the Indian population are scarce. Our study intends to compare the outcomes of these pathways in the Indian community focusing on hospital stay, postoperative pain, and time for rescue analgesia. Materials and Methods This is a single-blinded RCT involving 112 patients who underwent laparoscopic sleeve gastrectomy (LSG). The groups were divided into ERAS and standard pathway arms by closed envelope technique. The primary outcome was the length of hospital stay, while the secondary outcomes included pain score; postoperative nausea, and vomiting (PONV); time for rescue analgesia; and ambulation. Results Of 112 patients included, 56 were allocated in the ERAS group, and the remaining 56 were included in the standard pathway group. We found no significant differences in the baseline characteristics between the two groups. Mean hospital stay was significantly lower in the ERAS group compared to the standard group (p = 0.003). In comparison to the standard group, ERAS patients were ambulated early, and the difference was highly significant (p < 0.001). Pain scores between the two groups showed a significant difference during the 4th hour and 8th hour. We also found a significant variation between the time for first rescue analgesia and the two groups (p < 0.001). Conclusion Patients who followed ERAS protocol were found to have shortened hospital stay, decreased pain, early ambulation, and reduced need for rescue analgesia. Trial Registration ClinicalTrials.gov Identifier: NCT03191318 Keywords ERAS . Standard pathway . LSG . RCT
Introduction Enhanced recovery after surgery (ERAS) protocols are multifaceted perioperative care pathways for surgical candidates to
achieve early recovery after surgery. Bariatric surgeries are considered to be high risk due to multiple comorbidities that exist in the bariatric patients and also due to difficulties encountered during anesthesia. The expected outcomes of an
* P. Praveen Raj [email protected]
S. Saravana Kumar [email protected]
S. Prabhakaran [email protected]
Sudarsan Kasthuri [email protected]
Shivanshu Misra [email protected]
Chinnusamy Palanivelu [email protected]
M. Magila [email protected]
1
Department of Bariatric and Metabolic Surgery, GEM Hospital & Research Center, Coimbatore, Tamil Nadu 641045, India
OBES SURG
ERAS protocol include reduced morbidity, early discharge, patient satisfaction, a
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