Enhanced recovery after surgery in paediatrics: a review of the literature

Enhanced recovery after surgery in paediatrics: a review of the literature

K. Roberts et al. Enhanced recovery after surgery in paediatrics: a review of the literature. BJA Education VOLUME 20, ISSUE 7, P235-241, JULY 01, 2020

What is already known:

The success of adult ERAS protocols has led to interest in creating paediatric ERAS pathways. Which has led to a great deal of interest in this area, culminating in the first World Congress for Paeds ERAS in 2018. Previous literature reviews on paediatric ERAS have identified a lack of prospective and randomised control trials in this area and have acknowledged that the creation and implementation of paediatric ERAS pathways has been slower than in adults. Adult and paediatric pathways obviously share many of the key ERAS principles. These include elements such as: preoperative education, reduced preoperative fasting, minimally invasive surgical techniques, multimodal opioid sparing analgesia including regional anaesthesia, minimising the use of surgical drains and early postoperative feeding and mobilisation.

What this paper adds:

Although robust, high-quality evidence is lacking, the available literature demonstrates reduced length of stay, use of opioids and intraoperative fluids, and time to restarting a regular diet with paediatric ERAS protocols.
This excellent review also discusses the key differences between adult and paediatric pathways and highlight other aspects such as physiological considerations based on a child’s developmental age. They also discuss the future directions for paediatric ERAS.

Chris Jones, Guildford.