Attitudes of patients and care providers to enhanced recovery after surgery programs after major abdominal surgery

Michael Hughes, Marielle M E Coolsen, Eirik K. Aahlin, Ewen M. Harrison, Stephen J. McNally, C. H C Dejong, Kristoffer Lassen, Stephen J. Wigmore

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Enhanced recovery after surgery (ERAS) is a well-established pathway of perioperative care in surgery in an increasing number of specialties. To implement protocols and maintain high levels of compliance, continued support from care providers and patients is vital. This survey aimed to assess the perceptions of care providers and patients of the relevance and importance of the ERAS targets and strategies. Materials and methods: Pre- and post-operative surveys were completed by patients who underwent major hepatic, colorectal, or oesophagogastric surgery in three major centers in Scotland, Norway, and The Netherlands. Anonymous web-based and article surveys were also sent to surgeons, anesthetists, and nurses experienced in delivering enhanced recovery protocols. Each questionnaire asked the responder to rate a selection of enhanced recovery targets and strategies in terms of perceived importance. Results: One hundred nine patients and 57 care providers completed the preoperative survey. Overall, both patients and care providers rated the majority of items as important and supported ERAS principles. Freedom from nausea (median, 10; interquartile range [IQR], 8-10) and pain at rest (median, 10; IQR, 8-10) were the care components rated the highest by both patients and care providers. Early return of bowel function (median, 7; IQR, 5-8) and avoiding preanesthetic sedation (median, 6; IQR, 3.75-8) were scored the lowest by care providers. Conclusions: ERAS principles are supported by both patients and care providers. This is important when attempting to implement and maintain an ERAS program. Controversies still remain regarding the relative importance of individual ERAS components.

Original languageEnglish
Pages (from-to)102-110
Number of pages9
JournalThe Journal of surgical research
Volume193
Issue number1
Early online date23 Jun 2014
DOIs
Publication statusPublished - Jan 2015

Keywords

  • Colorectal surgery
  • Enhanced recovery after surgery
  • ERAS
  • Fast track recovery program
  • Liver surgery
  • Oesophagogastric surgery

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