Implementation of the Enhanced Recovery After Surgery (ERAS®) program in neurosurgery

作者：Amani Belouaer, Giulia Cossu, Georgios E. Papadakis, John G. Gaudet, Marie‐Hélène Perez, Vivianne Chanez, Yann Boegli, Caroline Mury, David R. Peters, Valérie Addor, Marc Levivier, Roy Thomas Daniel, Nicolas Demartines, Mahmoud Messerer · 发表于：Acta Neurochirurgica · 年份：2023 · DOI：10.1007/s00701-023-05789-y · 被引用次数：19 · 研究领域：Enhanced Recovery After Surgery、Nutrition and Health in Aging、Nausea and vomiting management

BACKGROUND: Over the past decade, Enhanced Recovery After Surgery (ERAS®) guidelines have been proven to simplify postoperative care and improve recovery in several surgical disciplines. The authors set out to create and launch an ERAS® program for cranial neurosurgery that meets official ERAS® Society standards. The authors summarize the successive steps taken to achieve this goal in two specific neurosurgical conditions and describe the challenges they faced. METHODS: Pituitary neuroendocrine tumors (Pit-NET) resected by a transsphenoidal approach and craniosynostosis (Cs) repair were selected as appropriate targets for the implementation of ERAS® program in the Department of Neurosurgery. A multidisciplinary team with experience in managing these pathologies was created. A specialized ERAS® nurse coordinator was hired. An ERAS® certification process was performed involving 4 seminars separated by 3 active phases under the supervision of an ERAS® coach. RESULTS: The ERAS® Pit-NET team included 8 active members. The ERAS® Cs team included 12 active members. Through the ERAS® certification process, areas for improvement were identified, local protocols were written, and the ERAS® program was implemented. Patient-centered strategies were developed to increase compliance with the ERAS® protocols. A prospective database was designed for ongoing program evaluation. Certification was achieved in 18 months. Direct costs and time requirements are reported. CONCLUSION: Successful ERA...