Basics of Enhanced Recovery
Components of Enhanced Recovery
Enhanced recovery after surgery, or ERAS, is a set of protocols used by the surgical team to help ensure a patient has the best possible outcome from their surgery. Important components of these protocols occur before, during, and after a procedure.
Benefits of the Enhanced Recovery Programs
Enhanced Recovery programs have been shown to be more safe and effective relative to traditional care. Many studies have demonstrated that, in addition to a decreased length of stay, the implementation of Enhanced Recovery protocols are associated with either decreased or invariable morbidity and mortality. One area of primary concern for any surgical procedure is inadequate pain management. Studies have found that Enhanced Recovery protocols can facilitate the optimization of postoperative analgesia. Specifically, protocols that have incorporated spinal anesthesia with intrathecal morphine have seen a decreased patient reliance on systemic opioids during the postoperative phase.
Another important aspect of Enhanced Recovery protocols is their ability to either accelerate the return of organ function, or prevent their decline. Considerable evidence exists demonstrating a reduction in the duration of ileus, as well as the prevention of pulmonary function decline during postoperative recovery for patients who have undergone Enhanced Recovery protocols. Optimal recovery of the musculoskeletal system, in the form of improved muscle function, improved physical strength, preserved lean body mass, and exercise performance, is also a well described benefit of Enhanced Recovery pathways. Compared with traditional management, ERAS pathways have the potential to improve patient quality of life, in both the immediate and long term post-surgical periods. Factors such as earlier resumption of normal activities, reduced need for daytime sleep, reduced fatigue, and reduced number of days that patients require sick leave have all been reported in patients for whom ERAS was implemented.