Many post-operative outcomes have been investigated and have been shown to be improved following implementation of an ERAS programme. The vast majority of these relate to inpatient stay and short-term (most commonly 30-90day) outcomes. Some studies have looked at longer-term outcomes including mortality and chronic pain and there is a strong association between chronic pain and opioid dependence.
What this paper adds:
This observational study identified a significant proportion of patients reporting persistent post-surgical pain (19%), dissatisfaction with their stay (14%) and hospital readmission (20%) within six months of their operation. These findings may suggest that a significant proportion of patients are suffering in the long-term following surgery despite being enrolled in an ERAS programme. The study did not, however, compare to outcomes before rolling-out an ERAS programme, nor did it give details of the programme itself. This study has demonstrated the potential for utilising automated telephone services as a screening tool for patients who may have experienced significant adverse outcomes postoperatively although they only achieved a 48% response rate. In an era where there is increasing concern over long-term opioid dependence, any methods which may help identify patients who have become opioid dependent should be investigated further.
The influence of peri-operative factors for accelerated discharge following laparoscopic colorectal surgery when combined with an enhanced recovery after surgery (ERAS) pathway. Chand M, De’Ath HD, Rasheed S, Mehta…