Effectiveness of Enhanced Recovery After Surgery (ERAS) Pathway in Reducing Length of Hospital Stay
DOI:
https://doi.org/10.53350/Annalspakmed.1.9.22Keywords:
Enhanced Recovery After Surgery, ERAS pathway, postoperative recovery, length of hospital stay, multimodal analgesia, elective abdominal surgery.Abstract
Background: Enhanced Recovery After Surgery (ERAS) is a model of perioperative care that utilizes evidence-based practice to minimize stress in surgery, early mobilization, and faster functional recovery. One of the ERAS targets is the reduction of length of hospital stay (LOS), which is of particular significance to resource-constrained healthcare systems like those found in Pakistan.
Objectives: This research was conducted to assess the effectiveness of the ERAS pathway to shorten LOS in adult patients undergoing elective abdominal surgery at tertiary care hospitals in Punjab, Pakistan. Secondary goals encompassed evaluation of postoperative pain, mobilization period, opioid analgesia, complications and a 30 days readmission rate.
Methods: The study was a prospective observational study that was carried out between June 2024 and August 2025 and involved 120 adults who are going to have an elective abdominal surgery. The participants were arbitrarily divided into an ERAS group (n=60) or a management group (n=60). The elements of ERAS were preoperative counselling, decreased fasting, carbohydrate loading, multimodal analgesia, early mobilization, and early enteral nutrition. The structural proforma was used to record LOS and secondary outcomes. Statistical evaluation was done in SPSS version 26 whereby independent t-tests and chi-square tests were used respectively.
Results: ERAS patients experienced a much shorter LOS (3.2 +/- 1.1 days) than conventional care patients (6.4 +/- 2.3 days). ERAS was also linked with an earlier mobilization (6.5 ± 2.3 hours), an earlier oral consumption (10.4 ± 3.1 hours), a lower postoperative pain rating, and a considerable decrease in opioid consumption. The ERAS group had fewer postoperative ileus and nausea/vomiting. There was no significant difference in 30 day readmission.
Conclusion: ERAS substantially decreases LOS and improves the recovery during the postoperative period without raising the rates of readmission. ERAS protocols can be incorporated in the day-to-day practice of surgery to enhance the perioperative outcomes and utilization of healthcare resources in Pakistan.
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