Enhanced recovery after surgery (ERAS) and its applicability for major spine surgery

Authors: Wainwright, T.W., Immins, T. and Middleton, R.G.

http://eprints.bournemouth.ac.uk/22937/

Journal: Best Practice & Research Clinical Anaesthesiology

DOI: 10.1016/j.bpa.2015.11.001

This article examines the relevance of applying the Enhanced Recovery after Surgery (ERAS) approach to patients undergoing major spinal surgery. The history of ERAS, details of the components of the approach, and the underlying rationale are explained. Evidence on outcomes achieved by using the ERAS approach in other orthopaedic and complex surgical procedures are then outlined. Data on major spinal surgery rates and current practice are reviewed and the rationale for the use of ERAS in major spinal surgery is discussed, and potential challenges to its adoption acknowledged. A thorough literature search is then undertaken to examine the use of ERAS pathways in major spinal surgery, and the results presented. The article then reviews the evidence to support the application of individual ERAS components such as patient education, multimodal pain management, surgical approach, blood loss, nutrition, and physiotherapy in major spinal surgery, and discusses the need for further robust research to be undertaken. The article concludes that given the rising costs of surgery and levels of patient dissatisfaction, an ERAS pathway that focuses on optimizing clinical procedures by adopting evidence-based practice, and improving logistics, should enable major spinal surgery patients to recover more quickly with lower rates of morbidity and improved longer term outcomes.

This data was imported from PubMed:

Authors: Wainwright, T.W., Immins, T. and Middleton, R.G.

http://eprints.bournemouth.ac.uk/22937/

Journal: Best Pract Res Clin Anaesthesiol

Volume: 30

Issue: 1

Pages: 91-102

eISSN: 1878-1608

DOI: 10.1016/j.bpa.2015.11.001

This article examines the relevance of applying the Enhanced Recovery after Surgery (ERAS) approach to patients undergoing major spinal surgery. The history of ERAS, details of the components of the approach and the underlying rationale are explained. Evidence on outcomes achieved by using the ERAS approach in other orthopaedic and complex surgical procedures is then outlined. Data on major spinal surgery rates and current practice are reviewed; the rationale for using ERAS in major spinal surgery is discussed, and potential challenges to its adoption are acknowledged. A thorough literature search is then undertaken to examine the use of ERAS pathways in major spinal surgery, and the results are presented. The article then reviews the evidence to support the application of individual ERAS components such as patient education, multimodal pain management, surgical approach, blood loss, nutrition and physiotherapy in major spinal surgery, and discusses the need for further robust research to be undertaken. The article concludes that given the rising costs of surgery and levels of patient dissatisfaction, an ERAS pathway that focuses on optimising clinical procedures by adopting evidence-based practice and improving logistics should enable major spinal surgery patients to recover more quickly with lower rates of morbidity and improved longer-term outcomes.

This data was imported from Scopus:

Authors: Wainwright, T.W., Immins, T. and Middleton, R.G.

http://eprints.bournemouth.ac.uk/22937/

Journal: Best Practice and Research: Clinical Anaesthesiology

Volume: 30

Issue: 1

Pages: 91-102

eISSN: 1532-169X

ISSN: 1521-6896

DOI: 10.1016/j.bpa.2015.11.001

© 2015 Elsevier Ltd. This article examines the relevance of applying the Enhanced Recovery after Surgery (ERAS) approach to patients undergoing major spinal surgery. The history of ERAS, details of the components of the approach and the underlying rationale are explained. Evidence on outcomes achieved by using the ERAS approach in other orthopaedic and complex surgical procedures is then outlined. Data on major spinal surgery rates and current practice are reviewed; the rationale for using ERAS in major spinal surgery is discussed, and potential challenges to its adoption are acknowledged. A thorough literature search is then undertaken to examine the use of ERAS pathways in major spinal surgery, and the results are presented. The article then reviews the evidence to support the application of individual ERAS components such as patient education, multimodal pain management, surgical approach, blood loss, nutrition and physiotherapy in major spinal surgery, and discusses the need for further robust research to be undertaken. The article concludes that given the rising costs of surgery and levels of patient dissatisfaction, an ERAS pathway that focuses on optimising clinical procedures by adopting evidence-based practice and improving logistics should enable major spinal surgery patients to recover more quickly with lower rates of morbidity and improved longer-term outcomes.

This data was imported from Web of Science (Lite):

Authors: Wainwright, T.W., Immins, T. and Middleton, R.G.

http://eprints.bournemouth.ac.uk/22937/

Journal: BEST PRACTICE & RESEARCH-CLINICAL ANAESTHESIOLOGY

Volume: 30

Issue: 1

Pages: 91-102

eISSN: 1878-1608

ISSN: 1521-6896

DOI: 10.1016/j.bpa.2015.11.001

This data was imported from Europe PubMed Central:

Authors: Wainwright, T.W., Immins, T. and Middleton, R.G.

http://eprints.bournemouth.ac.uk/22937/

Journal: Best practice & research. Clinical anaesthesiology

Volume: 30

Issue: 1

Pages: 91-102

eISSN: 1878-1608

ISSN: 1521-6896

This article examines the relevance of applying the Enhanced Recovery after Surgery (ERAS) approach to patients undergoing major spinal surgery. The history of ERAS, details of the components of the approach and the underlying rationale are explained. Evidence on outcomes achieved by using the ERAS approach in other orthopaedic and complex surgical procedures is then outlined. Data on major spinal surgery rates and current practice are reviewed; the rationale for using ERAS in major spinal surgery is discussed, and potential challenges to its adoption are acknowledged. A thorough literature search is then undertaken to examine the use of ERAS pathways in major spinal surgery, and the results are presented. The article then reviews the evidence to support the application of individual ERAS components such as patient education, multimodal pain management, surgical approach, blood loss, nutrition and physiotherapy in major spinal surgery, and discusses the need for further robust research to be undertaken. The article concludes that given the rising costs of surgery and levels of patient dissatisfaction, an ERAS pathway that focuses on optimising clinical procedures by adopting evidence-based practice and improving logistics should enable major spinal surgery patients to recover more quickly with lower rates of morbidity and improved longer-term outcomes.

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