Jaime Ruiz-Tovar1, Alejandro Garcia2, Carlos Ferrigni2, Juan Gonzalez2, Camilo Castellon2, Manuel Duran2. 1. Centro de Excelencia para el Estudio y Tratamiento de la Obesidad, Valladolid, Spain; Department of Surgery. Bariatric Surgery Unit. University Hospital Rey Juan Carlos, Madrid, Spain. Electronic address: jruiztovar@gmail.com. 2. Department of Surgery. Bariatric Surgery Unit. University Hospital Rey Juan Carlos, Madrid, Spain.
Abstract
BACKGROUND: The essence of enhanced recovery after surgery (ERAS) program is the multimodal approach, and many authors have demonstrated safety and feasibility in fast-track bariatric surgery. OBJECTIVES: The aim of this study was to evaluate the postoperative pain after the implementation of an ERAS protocol in Roux-en-Y gastric bypass and to compare it with the application of a standard care protocol. SETTING: University Hospital Rey Juan Carlos, Madrid, Spain. METHODS: A prospective randomized clinical trial of all the patients undergoing Roux-en-Y gastric bypass was performed. Patients were randomized into the following 2 groups: those patients after an ERAS program and those patients after a standard care protocol. Postoperative pain, nausea or vomiting, morbidity, mortality, hospital stay, and analytic acute phase reactants 24 hours after surgery were evaluated. RESULTS:One hundred eighty patients were included in the study, 90 in each group. Postoperative pain (16 versus 37 mm; P < .001), nausea or vomiting (8.9% versus 2.2%; P = .0498), and hospital stay (1.7 versus 2.8 d; P < .001) were significantly lower in the ERAS group. There were no significant differences in complications, mortality, and readmission rates. White blood cell count, serum fibrinogen, and C reactive protein levels were significantly lower in the ERAS group 24 hours after surgery. CONCLUSION: The implementation of an ERAS protocol was associated with lower postoperative pain, reduced incidence of postoperative nausea or vomiting, lower levels of acute phase reactants, and earlier hospital discharge. Complications, reinterventions, mortality, and readmission rates were similar to that obtained after a standard care protocol.
RCT Entities:
BACKGROUND: The essence of enhanced recovery after surgery (ERAS) program is the multimodal approach, and many authors have demonstrated safety and feasibility in fast-track bariatric surgery. OBJECTIVES: The aim of this study was to evaluate the postoperative pain after the implementation of an ERAS protocol in Roux-en-Y gastric bypass and to compare it with the application of a standard care protocol. SETTING: University Hospital Rey Juan Carlos, Madrid, Spain. METHODS: A prospective randomized clinical trial of all the patients undergoing Roux-en-Y gastric bypass was performed. Patients were randomized into the following 2 groups: those patients after an ERAS program and those patients after a standard care protocol. Postoperative pain, nausea or vomiting, morbidity, mortality, hospital stay, and analytic acute phase reactants 24 hours after surgery were evaluated. RESULTS: One hundred eighty patients were included in the study, 90 in each group. Postoperative pain (16 versus 37 mm; P < .001), nausea or vomiting (8.9% versus 2.2%; P = .0498), and hospital stay (1.7 versus 2.8 d; P < .001) were significantly lower in the ERAS group. There were no significant differences in complications, mortality, and readmission rates. White blood cell count, serum fibrinogen, and C reactive protein levels were significantly lower in the ERAS group 24 hours after surgery. CONCLUSION: The implementation of an ERAS protocol was associated with lower postoperative pain, reduced incidence of postoperative nausea or vomiting, lower levels of acute phase reactants, and earlier hospital discharge. Complications, reinterventions, mortality, and readmission rates were similar to that obtained after a standard care protocol.
Authors: Piotr Małczak; Michał Wysocki; Hanna Twardowska; Alicja Dudek; Justyna Tabiś; Piotr Major; Magdalena Pisarska; Michał Pędziwiatr Journal: Obes Surg Date: 2020-04 Impact factor: 4.129
Authors: Yuwen Chen; Yiziting Zhu; Kunhua Zhong; Zhiyong Yang; Yujie Li; Xin Shu; Dandan Wang; Peng Deng; Xuehong Bai; Jianteng Gu; Kaizhi Lu; Ju Zhang; Lei Zhao; Tao Zhu; Ke Wei; Bin Yi Journal: Front Med (Lausanne) Date: 2022-09-14