An Optimized Enhanced Recovery After Surgery (ERAS) Pathway Improved Patient Care in Adolescent Idiopathic Scoliosis Surgery: A Retrospective Cohort Study

• Published in: World neurosurgery Vol. 145; pp. e224 - e232
• Main Authors: Yang, Yu-Jie, Huang, Xin, Gao, Xiao-Ning, Xia, Bing, Gao, Jian-Bo, Wang, Chen, Zhu, Xiao-Ling, Shi, Xiao-Juan, Tao, Hui-Ren, Luo, Zhuo-Jing, Huang, Jing-Hui
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2021
• Subjects: Adolescent; Adolescent idiopathic scoliosis (AIS); Cohort Studies; Enhanced Recovery After Surgery; Enhanced Recovery After Surgery (ERAS); Female; Humans; Length of stay; Male; Multimodal analgesia; Perioperative management; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Retrospective Studies; Scoliosis - surgery; Scoliosis correction surgery; Spinal Fusion - adverse effects; Spinal Fusion - methods; PONV; PSF; COX-2; POD; Perioperative management; AIS; Enhanced Recovery After Surgery (ERAS); LOS; Adolescent idiopathic scoliosis (AIS); ABT; Scoliosis correction surgery; TXA; Multimodal analgesia; Length of stay; ERAS
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2020.10.009

An optimized Enhanced Recovery After Surgery (ERAS) program is lacking for adolescent idiopathic scoliosis (AIS). The aim of the present study was to evaluate the impact and feasibility of an optimized ERAS pathway in patients with surgically treated AIS. In total, 79 patients with AIS who underwent corrective surgery without 3-column osteotomy were recruited from Xijing Hospital of the Fourth Military Medical University between 2012 and 2018. Forty-four patients were treated according to a traditional protocol and 35 were managed using an optimized ERAS pathway, which was designed and implemented by a multidisciplinary team. The following data were collected and retrospectively analyzed, demographic characteristics, Cobb angle, curve type (Lenke), surgical duration, fusion level, correction rate, estimated blood loss, postoperative hemoglobin level, postoperative pain score, pain relief time, hemovac drainage, drainage removal time, first ambulation time, length of hospital stay, and postoperative complications. There was no significant difference between the traditional and ERAS groups with respect to demographic characteristics, Cobb angle, curve type (Lenke), fusion level, and correction rate. However, the ERAS group had a shorter surgical duration, less blood loss and hemovac drainage, a higher postoperative hemoglobin level, and earlier pain relief, ambulation, and discharge. The rates of postoperative nausea and vomiting were lower in the ERAS group than in the traditional group. The ERAS pathway is capable of improving the perioperative status of patients with AIS by offering stronger analgesia, faster ambulation, and earlier discharge.