Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery: A ReviewShow others and affiliations
2021 (English)In: JAMA Surgery, ISSN 2168-6254, E-ISSN 2168-6262, Vol. 56, no 8, p. 775-784Article, review/survey (Refereed) Published
Abstract [en]
Importance: Enhanced Recovery After Surgery (ERAS) is a global surgical quality improvement initiative now firmly entrenched within the field of perioperative care. Although ERAS is associated with significant clinical outcome improvements and cost savings in numerous surgical specialties, several opportunities and challenges deserve further discussion.
Observations: Uptake and implementation of ERAS Society guidelines, together with ERAS-related research, have increased exponentially since the inception of the ERAS movement. Opportunities to further improve patient outcomes include addressing frailty, optimizing nutrition, prehabilitation, correcting preoperative anemia, and improving uptake of ERAS worldwide, including in low- and middle-income countries. Challenges facing enhanced recovery today include implementation, carbohydrate loading, reversal of neuromuscular blockade, and bowel preparation. The COVID-19 pandemic poses both a challenge and an opportunity for ERAS.
Conclusions and Relevance: To date, ERAS has achieved significant benefit for patients and health systems; however, improvements are still needed, particularly in the areas of patient optimization and systematic implementation. During this time of global crisis, the ERAS method of delivering care is required to take surgery and anesthesia to the next level and bring improvements in outcomes to both patients and health systems.
Place, publisher, year, edition, pages
American Medical Association , 2021. Vol. 56, no 8, p. 775-784
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-91352DOI: 10.1001/jamasurg.2021.0586ISI: 000644322900006PubMedID: 33881466Scopus ID: 2-s2.0-85105241358OAI: oai:DiVA.org:oru-91352DiVA, id: diva2:1546400
2021-04-222021-04-222023-12-08Bibliographically approved