Student and Faculty Publications
Publication Date
11-1-2023
Journal
Cureus
Abstract
STUDY OBJECTIVE: This study aimed to determine the effect of the implementation of the Enhanced Recovery After Surgery (ERAS) protocol among patients receiving minimally invasive gynecologic surgery.
DESIGN AND SETTING: This retrospective cohort study was performed in a tertiary care hospital.
PATIENTS: A total of 328 females who underwent minimally invasive gynecologic surgeries requiring at least one overnight stay at Keck Hospital of University of Southern California (USC), California, USA, from 2016 to 2020 were included in this study.
INTERVENTIONS: The institutional ERAS protocol was implemented in late 2018. A total of 186 patients from 2016 to 2018 prior to the implementation were compared to 142 patients from 2018 to 2020 after the implementation. Intraoperatively, the ERAS group received a multimodal analgesic regimen (including bilateral quadratus lumborum (QL) blocks) and postoperative care geared toward a satisfactory, safe, and expeditious discharge.
MEASUREMENTS AND MAIN RESULTS: The two groups were similar in demographics, except for the shorter surgical time noted in the ERAS group. The median opioid use was significantly less among the ERAS patients compared with the non-ERAS patients on postoperative day 1 (7.5 vs. 14.3 mg; p
CONCLUSIONS: The ERAS pathway was associated with a reduction in opioid use postoperatively and a shorter length of hospital stay after minimally invasive gynecologic surgery. There was a more significant decrease in opioid use and hospital length of stay for patients with malignant diagnoses compared to patients with benign diagnoses. Further research can be done to fully delineate the effect of QL blocks in ERAS protocols.
Keywords
peri-operative analgesia, regional anesthesiology, chronic and acute pain management, enhanced recovery pathways (eras), oncological gynecology
Included in
Bioinformatics Commons, Biomedical Informatics Commons, Health Psychology Commons, Medical Sciences Commons, Mental and Social Health Commons, Obstetrics and Gynecology Commons, Oncology Commons, Pain Management Commons, Surgery Commons
Comments
PMID: 38130508