Enhanced recovery after surgery (ERAS) for adolescent idiopathic scoliosis: Standardisation of care improves patient outcomes - 10/09/22
, Chrystelle Sola a, b, Anne Charlotte Saour a, Kevin Chapron a, Lucie Coruble a, Sophie Bringuier c, Christophe Dadure a, bAbstract |
Introduction |
Adolescent idiopathic scoliosis (AIS) surgeries are major paediatric procedures requiring multidisciplinary management. Enhanced recovery after surgery (ERAS) programs, with proven benefits in adults, remain poorly developed in paediatrics. The main objective of this Before/After study was to evaluate the impact of an ERAS program implementation for AIS on length of stay (LOS) and postoperative recovery.
Methods |
The ERAS protocol included intrathecal morphine, standardised multimodal analgesia and multidisciplinary measures for early recovery. Retrospective data from adolescents operated between 2015 and 2017 (“Before ERAS” group) were compared with data from patients benefiting from the ERAS program (“After ERAS” group). Patients treated for neuromuscular scoliosis were not included. After a descriptive analysis, a propensity score matching defined two comparable populations. The main outcome was the LOS. The time to first solid food intake, first ambulation, first bowel movement and Foley removal were also analysed.
Results |
During the "Before ERAS” period, 73 underwent PSF for AIS. Thereafter, 65 patients benefited from the ERAS protocol, including 35 for AIS. After propensity score application, 32 patients of the “After ERAS” group were matched with 32 patients of the “Before ERAS” group. The ERAS implementation was associated with 25% reduction in LOS (2.10 ± 1.60 days p < 0.001). All other enhanced recovery criteria were significantly reduced after ERAS implementation.
Conclusion |
These results confirm the expected benefits of ERAS program in AIS with a significant impact on postoperative recovery and LOS. Patient adherence and the involvement of all caregivers are essential to the success of such a program.
Le texte complet de cet article est disponible en PDF.Abbreviations : ERAS, AIS, PSF, LOS, CNIL, PCA, POD, PACU, ICU, BIS, PONV, NSAIDs, BMI, EPO, Hb, IV
Keywords : Enhanced recovery after surgery, Adolescent idiopathic scoliosis, Posterior spinal fusion, Multimodal analgesia, Paediatric anaesthesia
Plan
Vol 41 - N° 5
Article 101116- octobre 2022 Retour au numéro
Article précédent
- Obstetric services in the UK during the COVID-19 pandemic: A national survey
- James Edward O’Carroll, Liana Zucco, Eleanor Warwick, Gill Arbane, Ramani Moonesinghe, Kariem El-Boghdadly, N Guo, Brendan Carvalho, Pervez Sultan, on behalf of the ObsQoR Collaborators
- Massive intraoperative red blood cell transfusion during lung transplantation is strongly associated with 90-day mortality
- Enora Atchade, Yoann Elmaleh, Nathalie Zappella, Sylvain Jean-Baptiste, Alexis Tran-Dinh, Sébastien Tanaka, Aurélie Snauwaert, Brice Lortat-Jacob, Orlando Goncalves, Cendrine Godet, Hervé Mal, Yves Castier, Christian de Tymowski, Philippe Montravers
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?