Enhanced Recovery Pathway in Gynecologic Surgery: Improving Outcomes Through Evidence-Based Medicine

Eleftheria Kalogera, Sean Christopher Dowdy

Research output: Contribution to journalReview article

38 Scopus citations

Abstract

A paucity of data exists regarding traditional perioperative practices (bowel preparation, NPO at midnight, liberal narcotics, PCA use, liberal fluids, prolonged bowel and bed rest). Enhanced Recovery after Surgery (ERAS) is an evidence-based approach to peri-operative care associated with improved outcomes including earlier return of gastrointestinal function, reduced opioid use, shorter hospital stay, and substantial cost reductions with stable complication and readmission rates. Basic principles include patient education, minimizing preoperative fasting, avoiding bowel preparation, preemptive analgesia, nausea/vomiting prophylaxis, perioperative euvolemia, no routine use of drain and nasogastric tubes, early mobilization, oral intake, and catheter removal, non-opioid analgesics, and preemptive laxatives.

Original languageEnglish (US)
Pages (from-to)551-573
Number of pages23
JournalObstetrics and Gynecology Clinics of North America
Volume43
Issue number3
DOIs
StatePublished - Sep 1 2016

Keywords

  • Abdominal hysterectomy
  • Benign
  • Enhanced recovery
  • Gynecologic surgery
  • Laparoscopic hysterectomy
  • Perioperative care
  • Vaginal hysterectomy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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