ERAS protocol for pediatric laparoscopic cholecystectomy promotes safe and early discharge

Yeh, Andrew; Butler, Gabriella; Strotmeyer, Stephen; Austin, Kelly; Visoiu, Mihaela; Cladis, Franklyn P.; Malek, Marcus M.

doi:10.1016/j.jpedsurg.2019.09.053

Cited by 28 publications

(7 citation statements)

References 14 publications

(20 reference statements)

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“…Yeh et al retrospectively reviewed a data of 250 paediatric patients who underwent LC with and without ERAS implementation. 21 The authors concluded on analysis that ERAS implementation facilitated single day discharge with lesser complications without readmissions or emergency department visits. All these studies have highlighted the advantages of ERAS pathway implementation for LC over conventional care.…”

Section: Discussionmentioning

confidence: 99%

Application of Enhanced Recovery after Surgery Pathways in Patients Undergoing Laparoscopic Cholecystectomy With and Without Common Bile Duct Exploration

Nair¹,

Al-Aamri²,

Borkar

et al. 2023

Sultan Qaboos Univ Med J

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Many researchers implemented enhanced recovery after surgery (ERAS) pathways for laparoscopic cholecystectomy (LC) and found it effective over conventional care. This review investigates the efficacy and safety of ERAS pathways implemented for LC over conventional practices. We searched PubMed/Medline, SCOPUS, CENTRAL, Ovid, and clinicaltrials.gov using relevant keywords to identify studies in which ERAS pathways in LC were compared with conventional pathways. The primary outcome was length of stay (LOS) from the day of surgery and the secondary outcomes were comparison of pain scores, postoperative nausea/vomiting (PONV), readmissions (within 30-days after surgery), complications (medical and surgical), time to first flatus, and cost. Out of 590 articles identified, 6 studies (n=1489 patients) fulfilled inclusion criteria and were used for qualitative and quantitative analysis. On pooled analysis, the LOS, time to first flatus, PONV, pain scores were significantly less in ERAS group than the conventional one. However, readmission and complications were comparable in both groups. Keywords: Cholecystectomy; Enhanced recovery After Surgery; Fast-track surgery; Laparoscopy; Meta-analysis; Perioperative care; Systematic review.

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Section: Discussionmentioning

confidence: 99%

Application of Enhanced Recovery after Surgery Pathways in Patients Undergoing Laparoscopic Cholecystectomy With and Without Common Bile Duct Exploration

Nair¹,

Al-Aamri²,

Borkar

et al. 2023

Sultan Qaboos Univ Med J

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“…However, procedure-specific, pediatric ERAS protocols are becoming more frequent, with recent publications drawing attention to the potential for quality improvement in this age group. [24][25][26] One significant obstacle to successful implementation of an ERAS protocol is the necessity of multidisciplinary buy-in. Administrators, anesthesia providers, nurses, and surgeons must work together to develop, support, and continually better such protocols to optimize patient results.…”

Section: Discussionmentioning

confidence: 99%

A Survey on Enhanced Recovery After Surgery (ERAS) Elements in Cleft Palate Repair

Grabar

Fligor

Kanack

et al. 2022

The Cleft Palate Craniofacial Journal

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This study aims to characterize current use, knowledge, and attitude toward ERAS protocols by academic craniofacial surgeons. Craniofacial surgeons were provided with electronic surveys. Electronic survey; Institutional tertiary surgeons. 102 cleft palate surgeons surveyed and 31 completed the survey (30.4%). None. Respondents rated their knowledge, use, and willingness to implement perioperative interventions modeled after adult ERAS protocols. Majority (67.7%) rated they were knowledgeable about ERAS. However, 61.3% “never use” a standardized protocol for cleft palate surgery. Only 3 ERAS elements are currently implemented by a majority of cleft surgeons: avoiding prolonged perioperative fasting (67.7%), using hypothermia prevention measures (74.2%), and minimizing use of opioids (62.5%). A large majority of respondents noted they never administer bolus (71.0%) or infusion (80.6%) dosing of tranexamic acid; most of these surgeons also indicated that administering tranexamic acid “would not be a valuable addition” (67.7% and 71.0%, respectively). Short-acting sedatives are used by 12.9% and by 16.1% of surgeons in all patients during extubation and postoperative recovery, respectively. By contrast, 22.6% never use such agents during extubation and 48.4% never use it during postoperative recovery. Overall, 67.7% of respondents replied that they would be willing to implement an ERAS protocol for cleft palate repair. Many respondents report using interventions compatible with an ERAS approach and the majority are willing to implement an ERAS protocol for cleft palate repair.

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“…Refer to the European Society for Pediatric Anaesthesiology (ESPA) pain committee guidance on the management of postoperative pain [170] (Grade A-Level High) 2. The use of a single intraoperative dose of dexamethasone is recommended [171][172][173][174][175][176][177] (Grade A-Level Moderate)…”

Section: Statementsmentioning

confidence: 99%

Pediatric robotic surgery: issues in management—expert consensus from the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI) and the Italian Society of Pediatric Surgery (SICP)

et al. 2022

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Background Pediatric robotic-assisted surgeries have increased in recent years; however, guidance documents are still lacking. This study aimed to develop evidence-based recommendations, or best practice statements when evidence is lacking or inadequate, to assist surgical teams internationally. Methods A joint consensus taskforce of anesthesiologists and surgeons from the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI) and the Italian Society of Pediatric Surgery (SICP) have identified critical areas and reviewed the available evidence. The taskforce comprised 21 experts representing the fields of anesthesia (n = 11) and surgery (n = 10) from clinical centers performing pediatric robotic surgery in the Italian cities of Ancona, Bologna, Milan, Naples, Padua, Pavia, Perugia, Rome, Siena, and Verona. Between December 2020 and September 2021, three meetings, two Delphi rounds, and a final consensus conference took place. Results During the first planning meeting, the panel agreed on the specific objectives, the definitions to apply, and precise methodology. The project was structured into three subtopics: (i) preoperative patient assessment and preparation; (ii) intraoperative management (surgical and anesthesiologic); and (iii) postoperative procedures. Within these phases, the panel agreed to address a total of 18 relevant areas, which spanned preoperative patient assessment and patient selection, anesthesiology, critical care medicine, respiratory care, prevention of postoperative nausea and vomiting, and pain management. Conclusion Collaboration among surgeons and anesthesiologists will be increasingly important for achieving safe and effective RAS procedures. These recommendations will provide a review for those who already have relevant experience and should be particularly useful for those starting a new program.

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ERAS protocol for pediatric laparoscopic cholecystectomy promotes safe and early discharge

Cited by 28 publications

References 14 publications

Application of Enhanced Recovery after Surgery Pathways in Patients Undergoing Laparoscopic Cholecystectomy With and Without Common Bile Duct Exploration

Application of Enhanced Recovery after Surgery Pathways in Patients Undergoing Laparoscopic Cholecystectomy With and Without Common Bile Duct Exploration

A Survey on Enhanced Recovery After Surgery (ERAS) Elements in Cleft Palate Repair

Pediatric robotic surgery: issues in management—expert consensus from the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI) and the Italian Society of Pediatric Surgery (SICP)

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