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01-01-2021 | Opioids | Original Article

Enhanced recovery after surgery and anesthetic outcomes in pediatric reconstructive urologic surgery

Authors: Daniel S. Han, Megan A. Brockel, Peter J. Boxley, M. İ. Dönmez, Amanda F. Saltzman, Duncan T. Wilcox, Kyle O. Rove

Published in: Pediatric Surgery International | Issue 1/2021

Abstract

Purpose

Enhanced recovery after surgery (ERAS) is a perioperative management strategy to hasten postoperative recovery. We examined the effects of a pilot implementation of ERAS for pediatric patients on anesthetic outcomes.

Methods

We performed a prospective case–control study utilizing an ERAS protocol in patients aged < 18 years undergoing urologic reconstruction that included a bowel anastomosis. Protocol elements included: multimodal analgesia, opioid minimization, and routine nausea/vomiting prophylaxis. ERAS patients were propensity-matched with historical controls. Outcomes of interest included maximum PACU pain score, time to first opioid, opioid-free days, and need for opioids on day of discharge.

Results

A total of 13 ERAS patients and 26 historical controls were included, with median ages 9.9 years (IQR 9.1–11) and 10.4 years (IQR 8.0–12.4), respectively. ERAS increased the percentage of patients who did not receive any intraoperative or postoperative opioids (0% vs 15%, p = 0.046 for both) and reduced maximum PACU pain score (3 vs 0, p < 0.001). The use of postoperative supplemental oxygen was decreased in the ERAS group (85% vs 38%, p = 0.013).

Conclusions

The implementation of an ERAS protocol appears to decrease postoperative pain, opioid usage, and positively impact other anesthetic outcomes in children undergoing urologic reconstructive surgery utilizing a bowel anastomosis.

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Title: Enhanced recovery after surgery and anesthetic outcomes in pediatric reconstructive urologic surgery
Authors: Daniel S. Han
Megan A. Brockel
Peter J. Boxley
M. İ. Dönmez
Amanda F. Saltzman
Duncan T. Wilcox
Kyle O. Rove
Publication date: 01-01-2021
Publisher: Springer Berlin Heidelberg
Keywords: Opioids
Opioids
Published in: Pediatric Surgery International / Issue 1/2021
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-020-04775-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Enhanced recovery after surgery and anesthetic outcomes in pediatric reconstructive urologic surgery

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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