Standardizing Perioperative Medications to Be Used in an Enhanced Recovery After Surgery Program Is Feasible in Percutaneous Nephrolithotomy Patients

Girgiss, Carol; Berger, Jonathan; Chen, Tony T.; Kelly, Erika M; Kong, Emily; Flores, Alec R.; Abedi, Garen; Bechis, Seth K.; Monga, Manoj; Sur, Roger L.

doi:10.1089/end.2022.0153

Cited by 9 publications

(4 citation statements)

References 23 publications

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“…It was shown that when treated perioperatively with nonsteroidal antiinflammatory medication instead of opioids, patients had a significantly shorter hospitalization post-surgery. 24,25…”

Section: Analgesicsmentioning

confidence: 99%

Current advances in pain regimens for percutaneous nephrolithotomy

Tomas Paneque,

John Richey,

Ahmad Abdelrazek

et al. 2023

CUAJ

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Introduction: Percutaneous nephrolithotomy (PCNL) causes pain and discomfort after surgery. The primary causes of immediate postoperative pain after PCNL are visceral pain from the ureters and kidneys, and body surface discomfort from incisions. Acute, untreated pain has the potential to develop into chronic pain, which remains a considerable burden for the rehabilitation of patients. The goal of this review was to describe the current options for treating pain post-PCNL. Methods: We conducted a literature review of all published manuscripts on pain protocols for patients undergoing PCNL and related topics; 50 published manuscripts were identified and reviewed. Results: PCNL morbidity must be reduced by an appropriate management of postoperative pain. Opioids, multimodal therapy, tubeless PCNL, reduced size of nephrostomy tube, and regional anesthesia are currently available for reducing postoperative pain. Conclusions: Implementing successful treatment strategies for postoperative pain after PCNL is key in reducing the morbidity and mortality of PCNL.

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“…It was shown that when treated perioperatively with nonsteroidal antiinflammatory medication instead of opioids, patients had a significantly shorter hospitalization post-surgery. 24,25…”

Section: Analgesicsmentioning

confidence: 99%

Current advances in pain regimens for percutaneous nephrolithotomy

Tomas Paneque,

John Richey,

Ahmad Abdelrazek

et al. 2023

CUAJ

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“…ERAS protocols have been applied to several types of surgery worldwide, including gynaecological tumour surgeries,25 gastrointestinal tumour surgeries,26 27 thoracic tumour surgeries28 and urological cancer surgeries 29–31. ERAS has also been adopted for the surgical treatment of PCNL 32 33. However, there is still uncertainty regarding the efficacy and safety of ERAS for perioperative care in PCNL.…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of enhanced recovery after surgery among patients undergoing percutaneous nephrolithotomy: protocol for a systematic review and meta-analysis

Liu,

Yue,

Xiao

et al. 2023

BMJ Open

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IntroductionEnhanced recovery after surgery is widely used in the perioperative period in the field of urology; however, it lacks comprehensive and systematic evidence supporting its efficacy and safety after percutaneous nephrolithotomy. This meta-analysis aimed to assess the safety and efficacy of enhanced recovery after percutaneous nephrolithotomy.Methods and analysisRelevant databases, including PubMed, Web of Science, Embase, The Cochrane Library, China Knowledge Resource Integrated Database, Wanfang Database, Chinese Biomedical Document Service System, and Chinese Science and Technology Journal Database, will be searched from their inception to 19 September 2022. Two researchers will independently screen the literature, extract data and evaluate the included studies. The Grading of Recommendations, Assessment, Development, and Evaluation will be used to assess the degree of certainty of the evidence. Based on the Cochrane Handbook V.5.1.0, the risk of bias assessment of the included randomised controlled trials will be assessed. Based on their randomisation method, allocation generation, concealment, blinding and follow-up, we will assess randomised controlled trials. Random-effects and fixed-effects models and subgroup analyses will be used for meta-analysis. RevMan V.5.4.1 will be used for data collection and meta-analysis.Ethics and disseminationDue to the nature of this systematic review, ethics approval is not required for this study. We will publish the results of this review in a peer-reviewed journal.PROSPERO registration numberCRD42023411520.

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“…Enhanced recovery after surgery (ERAS) programs involve an evidence‐based, multidisciplinary approach to improving perioperative outcomes. These programs have demonstrated a profound impact in other health care disciplines, including transplant medicine, orthopedic surgery, colorectal surgery, and urology 8–11 . Although ERAS programs have been shown to be beneficial in other spine surgery fields such as degenerative disease and adult spinal deformities, there is a paucity of literature evaluating the feasibility, implementation, and outcomes of an ERAS program dedicated to metastatic spine tumor surgery 12–14 .…”

Section: Introductionmentioning

confidence: 99%

“…These programs have demonstrated a profound impact in other health care disciplines, including transplant medicine, orthopedic surgery, colorectal surgery, and urology. [8][9][10][11] Although ERAS programs have been shown to be beneficial in other spine surgery fields such as degenerative disease and adult spinal deformities, there is a paucity of literature evaluating the feasibility, implementation, and outcomes of an ERAS program dedicated to metastatic spine tumor surgery. [12][13][14] Early work by Grasu et al 15 demonstrated its feasibility and potential effectiveness on perioperative pain control and opioid consumption along with its impact on recovery for metastatic spine surgery patients.…”

Section: Introductionmentioning

confidence: 99%

Patient outcomes following implementation of an enhanced recovery after surgery pathway for patients with metastatic spine tumors

Chakravarthy

Laufer

Amin

et al. 2022

Cancer

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Background Metastatic spine tumor surgery consists of palliative operations performed on frail patients with multiple medical comorbidities. Enhanced recovery after surgery (ERAS) programs involve an evidence‐based, multidisciplinary approach to improve perioperative outcomes. This study presents clinical outcomes of a metastatic spine tumor ERAS pathway implemented at a tertiary cancer center. Methods The metastatic spine tumor ERAS program launched in April 2019, and data from January 2018 to May 2020 were reviewed. Measured outcomes included the following: hospital length of stay (LOS), time to ambulation, urinary catheter duration, time to resumption of diet, intraoperative fluid intake, estimated blood loss (EBL), and intraoperative and postoperative day 0–5 cumulative opioid use (morphine milligram equivalent [MME]). Results A total of 390 patients were included in the final analysis: 177 consecutive patients undergoing metastatic spine tumor surgery enrolled in the ERAS program and 213 consecutive pre‐ERAS patients. Although the mean case durations were similar in the ERAS and pre‐ERAS cohorts (265 vs. 274 min; p = .22), the ERAS cohort had decreased EBL (157 vs. 215 ml; p = .003), decreased postoperative day 0–5 cumulative mean opioid use (178 vs. 396 MME; p < .0001), earlier ambulation (mean, 34 vs. 57 h; p = .0001), earlier discontinuation of urinary catheters (mean, 36 vs. 56 h; p < .001), and shorter LOS (5.4 vs. 7.5 days; p < .0001). Conclusions The implementation of a multidisciplinary ERAS program designed for metastatic spine tumor surgery led to improved clinical quality metrics, including shorter hospitalizations and significant reductions in opioid consumption.

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Standardizing Perioperative Medications to Be Used in an Enhanced Recovery After Surgery Program Is Feasible in Percutaneous Nephrolithotomy Patients

Cited by 9 publications

References 23 publications

Current advances in pain regimens for percutaneous nephrolithotomy

Current advances in pain regimens for percutaneous nephrolithotomy

Safety and efficacy of enhanced recovery after surgery among patients undergoing percutaneous nephrolithotomy: protocol for a systematic review and meta-analysis

Patient outcomes following implementation of an enhanced recovery after surgery pathway for patients with metastatic spine tumors

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