ERAS Society sessions in Shanghai viewed over 50,000 times

The ERAS Society cooperated in arranging the OCAP2020 (Oriental Congress of Anesthesiology and Perioperative Medicine) congress in Shanghai in October. This congress was huge success with more than 4,000 delegates in place at the venue in Shanghai and with more than 50,000 delegates attending the ERAS Society day long session on line. In this session speakers from the ERAS Society alongside experts from inside and outside China delivered up to date presentations about ERAS.

We are grateful to Professor Miao the main host of the congress and his excellent team for a very nice and fruitful collaboration and we look forward to working with our Chinese colleagues to further spread ERAS in China and Asia.

In due course, members of the ERAS Society will be able to watch the presentations via the website.

You can join the society via our membership page 

ERAS® Society 10th anniversary World day – 14th Nov 2020

 

 

Join colleagues from around the world for the ERAS® Society 10th anniversary World day.

This global webinar will take place on the 14th November, 2020

Clinical experts in the ERAS® Society from around the world will deliver a series of short lectures and discuss key ERAS® papers. Join the free webinar from wherever you are!

ERAS Society Webinar Programme and Speaker Biographies 14 Nov 2020

Register for the time zone that suits you by clicking on the links below:

Asia and Australia 

Time Zone 1 https://us02web.zoom.us/webinar/register/WN_yrNyHf6tTjKX4kSqjftBaA

Africa and Europe

Time Zone 2  https://us02web.zoom.us/webinar/register/WN_nk0Kwrz8Q2mcu87IUlcZ9Q

Latin America and USA 

Time Zone 3 https://us02web.zoom.us/webinar/register/WN_iDqRqE2IQNqPTTU5gDtbrQ

If you are an ERAS® Society member, the webinars will also be available to view afterwards. To join the ERAS® Society click here

 

Following the three webinars, the ERAS Society USA Chapter, invites you to join them for their virtual conference “ERAS Updates and Future Directions”. Please find below the link to ERAS® USA Program and how to register

https://erasusa.org/meetings/virtual/2020/program/

 

European Society of Anaesthesiology and Intensive Care (ESAIC)

The ERAS® Society is a Specialist Society member of the newly renamed European Society of Anaesthesiology and Intensive Care (ESAIC). Previously the European Society of Anaesthesiology, ESAIC has more the 9,700 full members and more than 20,000 associate members. It remains the second largest Anaesthesia Society globally and holds the most prominent position in the community of anaesthesiologist in Europe and elsewhere. To visit the ESAIC website click here.

 

The Euroanaesthesia Virtual Congress is coming soon (28-30 November 2020) and is Europe’s largest annual event showcasing the latest news and innovations with medical experts active in the field of anaesthesia, perioperative medicine, intensive care, emergency medicine, and pain treatment. For more information please click here.

 

 

Pre-operative Patient Education – Bite Size Education Series Video

This is a short interview with nurses Jennie Burch and Angie Balfour. It aims to highlight the importance of preoperative patient education, a cornerstone principle of ERAS, which aims to prepare patients for their operation and their recovery.

Both Angie and Jennie have been working as ERAS nurses for over a decade in Edinburgh, Scotland and St Mark’s Hospital, London. They have seen ERAS evolve over time and have watched it’s implementation spread from one specialty to another reaching to all patients who have elective surgical procedures.

Jennie and Angie have also written a chapter featured in the ERAS textbook (available here)

Registration now open for ERAS® Society 10th anniversary webinars on 14th Nov 2020

Registration is now open for the previously announced, ERAS® Society 10th anniversary World day.

This global webinar will take place on the 14th November, 2020

Clinical experts in the ERAS® Society from around the world will deliver a series of short lectures and discuss key ERAS® papers. Join the free webinar from wherever you are!

Click here for the programme

 

Register for the time zone that suits you by clicking on the links below:

Asia and Australia 

Time Zone 1 https://us02web.zoom.us/webinar/register/WN_yrNyHf6tTjKX4kSqjftBaA

Africa and Europe

Time Zone 2  https://us02web.zoom.us/webinar/register/WN_nk0Kwrz8Q2mcu87IUlcZ9Q

Latin America and USA 

Time Zone 3 https://us02web.zoom.us/webinar/register/WN_iDqRqE2IQNqPTTU5gDtbrQ

 

If you are an ERAS® Society member, the webinars will also be available to view afterwards. To join the ERAS® Society click here

ERAS SOCIETY® 10th ANNIVERSARY – WORLD DAY

 

We are delighted to announce a global ERAS SOCIETY® webinar on 14th November 2020 spaced several hours apart  for three different time zones. There will be a number of lectures and key papers with input from major contributors to Worldwide ERAS, including our Chairman, Professor Olle Ljungqvist and other members of the Executive Committee. Choose a  time that suits you! 

We look forward to welcoming you to this free webinar, which will be available free to ERAS SOCIETY® members to view after the event. 

Stopping opioid-related addiction, harm and accidents after surgery – international experts come together to publish guidance

The opioid crisis, in which addiction and harm are related to pain-relieving opioid drugs, has been well documented. It has been concentrated in the USA but is now affecting most Western nations and increasingly, developing countries also. In some cases, this addiction and subsequent harm begins when the patient is given these drugs for pain relief after surgery.

To help confront this, an international group of global experts including anaesthetists, surgeons and other healthcare professionals have come together to publish a consensus statement on the prevention of opioid-related harm in adult surgical patients. The consensus statement is published in Anaesthesia (a journal of the Association of Anaesthetists).

“Opioids are effective medicines that form an integral component of balanced multimodal painkilling strategies for the management of acute pain in postoperative patients,” explain the statement co-authors, who include Professor Dileep Lobo, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen’s Medical Centre, Nottingham, UK. “However, over the past decade it has been increasingly appreciated that, in efforts to improve pain relief after surgery, doctors prescribing these drugs to help pain relief during and after surgery have unwittingly contributed to persistent postoperative opioid use, abuse and harm in some patients.”

They add: “In addition to the social and economic costs of opioid misuse, there are personal costs, with many people dying from opioid overdose, or in accidents caused, for example, by driving under the influence of opioids.”

Ways to reduce possible harm begin before surgery, since the strongest predictor of persistent postoperative opioid use post-surgery is pre-existing chronic opioid use. The incidence of persistent postoperative opioid use can be up to 10 times higher in those taking opioids long- term before surgery than in patients who have never used opioids.

The main points from the consensus statement are:

  • All patients undergoing surgery should be assumed to be at risk of developing persistent postoperative opioid use/addiction and may need interventions to mitigate those risks. However, some patients are at particularly high-risk of opioid related respiratory impairment, including older patients; those with sleep-disordered breathing; obesity; kidney disease; respiratory, cardiac and neurological diseases; diabetes; tolerance to opioids; and genetic variations in opioid metabolism.
  • Healthcare teams must consider optimising management of pre-operative pain and psychological risk-factors before surgery, including weaning patients off opioids they are already taking where possible. They should ensure realistic expectations of postoperative pain control, both in hospital and after discharge.
  • Provision of opioid painkillers should be guided by functional outcomes, rather than just a rating of the patient’s pain using existing scales.
  • Multiple methods of pain management should be optimised, and patients educated about the use of non-pharmacological and non-opioid painkilling strategies to reduce the amount and duration of opioids required to restore function
  • Long-acting opioids should not be used routinely for acute postoperative pain. (e.g. modified-release oxycodone, transdermal fentanyl patches)
  • A patient-centred approach should be used to limit the number of tablets and the duration of usual discharge opioid prescriptions, typically to less than a week. (Post-discharge prescriptions of opioids, if necessary, should be limited to less than a week’s duration. A small number of patients may need repeat prescriptions, but these should not be automatic. GPs should see patients and assess them before re-prescribing opioids).
  • Automated post-discharge repeat prescriptions for opioids should be avoided. Doctors, including those in outpatient clinics and general practice, should perform a patient review if more opioids are requested. Research has shown each additional repeat prescription has been found to increase the risk of opioid misuse (encompassing diagnoses of opioid dependence; abuse; or overdose) by 40%, with each additional week of opioids taken raising the risk of misuse by 20%. (A small number of patients may need repeat prescriptions, but these should not be automatic. GPs should see patients and assess them before re-prescribing opioids).
  • Patients should be advised on safe storage and disposal of unused opioids and directed to avoid opioid diversion to other individuals (e.g. sharing with friends and family). Addiction surveys have shown that around 50% of adults who misuse opioids obtain them from friends and family. This also avoids accidental deaths. Paediatric mortality from unintentional opioid overdose has increased three-fold in the last 20 years and has followed a similar time trend to adult overdose deaths

The authors also highlight the dangers of driving under the influence of opioids, that can impair driving skills and cognitive reasoning in a similar manner to alcohol. “Driving under the influence of drugs, including prescribed opioids, is now recognised to be a major cause of motor vehicle collisions and subsequent fatalities, particularly if the person commenced the opioid within the previous 30 days,” explain the authors, who add that many countries have established laws making driving under the influence of opioids illegal.

They conclude: “While the use of opioids during and after surgery has the capacity to promote recovery after life-saving or life-enhancing surgery, their use can be associated with harm from persistent postoperative opioid use; opioid-induced respiratory impairment; opioid diversion to people they were not originally prescribed for; and driving under the influence of prescription opioids. Strict control of opioid use within hospitals (stewardship) is required to minimise the risk of opioid-related harm. This will require the multidisciplinary involvement of anaesthetists; surgeons; pain specialists; pharmacists; nursing staff; physiotherapists; primary care clinicians; hospital management; and patients to adopt the recommendations from this consensus statement to local practice.”

Click here for the article

Professor Dileep Lobo, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen’s Medical Centre, Nottingham, UK. +44-7545966471) dileep.lobo@nottingham.ac.uk

Co-author Dr Kariem El-Boghdadly, Consultant Anaesthetist, Guy’s and St Thomas’ NHS Foundation Trust, London, UK. Please e-mail first to arrange interview. T) +44 7958 904883 E) editor-kariem@anaesthetists.org

Co-author and expert on pain medicine and addiction: Dr Jane Quinlan, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. T) +44 7545 995 615 E) jane.quinlan@ouh.nhs.uk

ERAS HIPEC guidelines now published in European Journal of Surgical Oncology

The ERAS Society is delighted to announce that the “Guidelines for Perioperative Care in Cytoreductive Surgery (CRS) with or without hyperthermic IntraPEritoneal chemotherapy (HIPEC): Enhanced Recovery After Surgery (ERAS®) Society Recommendations” have now been published in 2 parts in the European Journal of Surgical Oncology.

The articles are both open access

Guidelines for Perioperative Care in Cytoreductive Surgery (CRS) with or without hyperthermic IntraPEritoneal chemotherapy (HIPEC): Enhanced recovery after surgery (ERAS®) Society Recommendations d Part I: Preoperative and intraoperative management

Guidelines for Perioperative Care in Cytoreductive Surgery (CRS) with or without hyperthermic IntraPEritoneal chemotherapy (HIPEC): Enhanced Recovery After Surgery (ERAS®) Society Recommendations — Part II: Postoperative management and special considerations

COVID-19 update to the ERAS® Interactive Audit System

The ERAS® Interactive Audit System, can now also be used to track your patient’s Covid-19 status. This will be beneficial for surgical teams to keep track of the patient’s Covid-19 status and identify how the patient’s Covid-19 status affects the outcome of care.

The selection items are based on the WHO Clinical Coding for Covid-19. Since some studies show long term effects in COVID patients, this data can be used to study how these cases respond to recovery after surgery in the long run.

The ERAS® Interactive Audit System comes with a set of protocols based on the ERAS® Society published guidelines and is used to register, measure, and audit your patient’s perioperative care process.

If you are using an audit system for ERAS® practice, there are some parameters that may be of high value to you for planning backlog surgeries and identifying the best perioperative measures. Please read more here.

Please contact Encare directly if you have questions regarding the ERAS® Interactive Audit System and how to implement ERAS®.