THE ROLE OF ENHANCED RECOVERY AFTER SURGERY PROTOCOLS IN ANAESTHESIA: EXAMINING HOW TAILORED ANAESTHETIC APPROACHES CONTRIBUTE TO FASTER RECOVERY AND REDUCED OPIOID DEPENDENCY

Abstract

Background: ERAS pathways are derived from Enhanced Recovery After Surgery and have changed the way by which patients are managed in the perioperative period. Enhanced Recovery after Surgery or ERAS has significant components that reveal an array of essential strategies to reduce postoperative pain as well as opioid consumption and achieve faster postoperative recovery, with special concern in the tailored anaesthetic methods.

Aim: This paper seeks to investigate the effects of ERAS specific anaesthesia practices on quantitative postoperative recovery indices, opioid utilization and patient satisfaction as compared to those resulting from traditional aesthetic protocols.

Method: This study was carried out at Ayub teaching hospital Abbottabad for duration of six months from November 2022 to April 2023. A dual approach involving an RCT study and case review methodology was used in this project. Patients undergoing elective surgery were divided into two groups: were patients who underwent ERAS-specific anaesthetic protocols and those who were on standard anaesthesia care. The parameters used for assessment were time to recovery, opioid requirements, patient satisfaction score and rate of complications. Descriptive statistics were also used to describe the pattern of observed results, while inferential statistics were used to determine the magnitude and directional effects of observed outcomes.

Results: ERAS tailored received a better outcome in terms of early ambulation with a median of 6.2 for the ERAS-tailored group compared to the 12.5 for the non-ERAS group and discharge readiness with a median of 3.4 for the ERAS-tailored group compared to 5.2 for the non-ERAS group. Optimal completion of the WODQOL-SBP questionnaires was achieved with postoperative opioid use cut by over half (18.7 MME vs. 48.9 MME). Furthermore, the ERAS group patients had better satisfaction with pain control (92% versus 75%), and less complications, including nausea and respiratory problems. All these results were statistically significant and further analysis showed that these were strong evidence (p < 0.01).

Conclusion: Implementation of specific anaesthetic regimens in frames of ERAS concepts enhances recovery, decreases opioid consumption, and increases patient satisfaction. The present results underscore the implementation of ERAS-specific anaesthesia principles to practice and confirm that more investigations should be conducted to investigate long-term efficacy and differences among various ethnicities.