Enhanced recovery after surgery (ERAS): A budding concept in neonatal intestinal surgery

Abstract

Enhanced recovery after surgery (ERAS) is a multidisciplinary approach, widely used in adults and children for improving patient care with reduced length of hospital stay and medical costs. However, it is poorly established and perceived as unimplementable in neonates. Recently, ERAS guidelines consisting of 17 recommendations for perioperative care in neonatal intestinal surgery are laid down by the ERAS society. To elicit the feasibility of implementing ERAS protocol, we did an observational pilot study in neonates undergoing intestinal surgery at a tertiary centre to know the number of recommendations from ERAS guidelines already being followed routinely.Data was collected for the neonates undergoing intestinal surgery for three months. All the relevant details were noted and analysed to find out the number of recommendations from ERAS guidelines already being implemented and the postoperative outcome of these neonates.Twelve neonates underwent intestinal surgery for obstruction and atresia during the study period. Eight out of 17 ERAS guidelines were already followed as a routine protocol in all these patients. Nine patients were extubated on table, one patient was extubated within 24 hours of surgery and two patients succumbed to death. Ten neonates were discharged from hospital within 6-8 days of surgery. Many recommendations from ERAS guidelines for neonatal intestinal surgery are already being followed routinely, suggesting that the implementation of complete ERAS protocol is easily possible, which may further improve the perioperative outcome with reduced length of hospital stay.