التفاصيل البيبلوغرافية
| العنوان: |
Enhanced recovery program for minimally invasive and vaginal urogynecologic surgery. |
| المؤلفون: |
Trowbridge, Elisa Rodriguez, Evans, Sarah L., Sarosiek, Bethany M., Modesitt, Susan C., Redick, Dana L., Tiouririne, Mohamed, Thiele, Robert H., Hedrick, Traci L., Hullfish, Kathie L. |
| المصدر: |
International Urogynecology Journal; Feb2019, Vol. 30 Issue 2, p313-321, 9p |
| مصطلحات موضوعية: |
UROGYNECOLOGIC surgery, PLASTIC surgery, AMBULATORY surgery, SURGICAL complications, PERIOPERATIVE care |
| مستخلص: |
Introduction and hypothesis: Enhanced recovery protocols (ERPs) are evidenced-based interventions designed to standardize perioperative care and expedite recovery to baseline functional status after surgery. There remains a paucity of data addressing the effect of ERPs on pelvic reconstructive surgery patients.Methods: An ERP was implemented at our institution including: patient counseling, carbohydrate loading, avoidance of opioids, goal-directed fluid resuscitation, immediate postoperative feeding and early ambulation. Patients undergoing elective pelvic reconstructive surgery before and after implementation of the ERP were identified in this cohort study.Results: One hundred eighteen patients underwent pelvic reconstructive surgery within the ERP compared with 76 historic controls. Reductions were seen in length of hospital stay (29.9 vs. 27.9 h, p = 0.04), total morphine equivalents (37.4 vs. 19.4 mg, p < 0.01) and total intravenous fluids administered (2.7 l vs. 1.5 l, p < 0.0001). Hospital discharges before noon doubled (32.9 vs. 60.2%, p < 0.01). More patients in the ERP group ambulated on the day of surgery (17.1 vs. 73.7%, p < 0.01) and ambulated at least two times the day following surgery (34.2 vs. 72.9%, p < 0.01). No differences were seen in average pain scores (highest pain score 7.39 vs. 7.37, p = 0.95), hospital readmissions (3.9 vs. 3.4%, p = 0.84), or postoperative complications (6.58 vs. 8.47%, p = 0.79). Patient satisfaction significantly improved. ERP was not associated with an increase in 30-day total hospital costs.Conclusions: Implementation of ERP for pelvic reconstructive surgery patients was associated with a reduced length of hospital stay, improved patient satisfaction, and decreased administration of intravenous fluids and opioids without an increase in complications, readmissions, or hospital costs. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
