Effectiveness of multimodal care interventions on enhanced recovery among the patients undergoing abdominal surgery

Abstract

Background: The perioperative phase includes a variety of procedures that aim to prepare the patient, physically and psychologically and prevent postoperative complications, thereby reducing the length of hospital stay. Objectives: This study includes the application of various measures to encourage active involvement and prompt participation of the patients in the enhanced recovery. Materials and Methods: A quasi-experimental design was used to evaluate the effectiveness of interventions on enhanced recovery among patients undergoing abdominal surgery at a tertiary care hospital, Mangaluru. Patients undergoing abdominal surgery between 20 to 60 years were selected as participants. Results: The majority of the participants (40%) belonged to the category of normal Body Mass Index (BMI) of 18.5-24.9 Kg/m2 in the experimental group and control group as per BMI categories for Asian populations. There was a significant difference in vital capacity scores between the experimental and control groups (P<0.05) on postoperative days 2 and 3. Thus it proved that deep breathing exercises are effective in improving pulmonary functions. In the experimental group, 60% received oral feed within 6 hours of surgery. The comparison of length of postoperative hospital stays in the experimental and control groups showed a significant difference between the groups (p<0.05) and the average postoperative hospital stay was 4 days in the experimental group. Conclusion: The enhanced surgery recovery protocol provides a faster recovery rate and fewer postoperative complications. These multimodal interventions are useful in routine practice for the optimal perioperative care for patients undergoing open abdominal surgery.