Published in:
Open Access 01-12-2020 | Nausea | Research article
"RETRACTED ARTICLE:Successful implementation of an enhanced recovery after surgery (ERAS) protocol reduces nausea and vomiting after infratentorial craniotomy for tumour resection: a randomized controlled trial
Published in: BMC Neurology | Issue 1/2020
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Background
Infratentorial craniotomy patients have a high incidence of
postoperative nausea and vomiting (PONV). Enhanced Recovery After Surgery (ERAS)
protocols have been shown in multiple surgical disciplines to improve outcomes,
including reduced PONV. However, very few studies have described the application
of ERAS to infratentorial craniotomy. The aim of this study was to examine
whether our ERAS protocol for infratentorial craniotomy could improve
PONV.
Methods
We implemented an evidence-based, multimodal ERAS protocol for
patients undergoing infratentorial craniotomy. A total of 105 patients who
underwent infratentorial craniotomy were randomized into either the ERAS group
(n = 50) or the control group (n = 55). Primary outcomes were the incidence of
vomiting, nausea score, and use of rescue antiemetic during the first 72 h after
surgery. Secondary outcomes included postoperative anxiety level, sleep quality,
and complications.
Results
Over the entire 72 h post-craniotomy observation period, the
cumulative incidence of vomiting was significantly lower in the ERAS group than
in the control group. Meanwhile, the incidence of vomiting was significantly
lower in the ERAS group on postoperative days (PODs) 2 and 3. Notably, the
proportion of patients with mild nausea (VAS 0–4) was higher in the ERAS group
as compared to the control group on PODs 2 or 3. Additionally, the postoperative
anxiety level and quality of sleep were significantly better in the ERAS
group.
Conclusion
Successful implementation of our ERAS protocol in infratentorial
craniotomy patients could attenuate postoperative anxiety, improve sleep
quality, and reduce the incidence of PONV, without increasing the rate of
postoperative complications.
Trial registration
ChiCTR-INR-16009662, 27 Oct 2016, Clinical study on the development and efficacy
evaluation of Enhanced Recovery After Surgery (ERAS) in Neurosurgery.