Editorial Comment on “Enhanced Recovery After Surgery (ERAS) in Head and Neck Oncologic Surgery: A Case-Matched Analysis of Perioperative and Pain Outcomes”

Excerpt

Enhanced recovery after surgery (ERAS) programs are multidisciplinary initiatives involving surgeons, anesthesiologists, coordinators, and nursing staff that aim to improve the perioperative patient experience and outcomes in major surgery.1 Over the past 2 decades, ERAS programs have been successfully implemented for perioperative care, first in colorectal surgery and then extended to other fields.2‐4 ERAS protocols call for optimizing elements of care that can significantly decrease perioperative morbidity and mortality.5 The principles of ERAS include patient education, goal-directed fluid management, multimodal analgesia, and early mobilization.6 Implementing ERAS pathways for major surgical procedures reduces hospital stays and complications, promotes maintenance of an anabolic state for better healing, and decreases reported pain and stress. The international ERAS society has published a series of guidelines with procedure-specific recommendations, however the evidence base for the interventions relevant to head and neck surgery was variable and amalgamated data from a variety of different head and neck cancer procedures. A consensus review recommended that elements relevant to perioperative care in head and neck cancer should be clinically evaluated in a more standardized fashion, highlighting the fact that head and neck surgery has not traveled as far along the ERAS path as other surgical fields.7 …