Introduction: The cost of healthcare in the U.S. has skyrocketed, prompting the need for more efficient approaches like Enhanced Recovery After Surgery (ERAS). ERAS is a set of guidelines helping patients recover quicker and cheaper after operations. While it has shown promise in many surgeries, brain and spine surgeons haven’t fully adopted it. The ERAS method can reduce stress from surgery, manage fluid intake, and enhance post-operation care. For spine surgeries, it’s been proven to cut costs by 15.2% and help patients recover faster. However, its widespread use faces challenges, including the need for teamwork among medical professionals and its application in emergency cases. This study sought to understand what neurosurgeons thought of ERAS protocols.
Methods: Neurosurgeons were surveyed using a 15-question form at the Congress of Neurological Surgeons 2019 Annual Meeting, and their responses were recorded.
Results: 39 brain surgeons from 38 different institutions responded to the survey. More than half of them said they’re using a ERAS to help patients recover faster after surgery. Most of these surgeons who use ERAS work in teaching hospitals. All of them use ERAS for spine surgeries, but only a few use it for other types of brain surgeries. Most hospitals create these ERAS plans by working with different types of medical experts. These plans mostly focus on what to do before and after surgery, like preparing the patient and helping them recover. The good news? Surgeons think these ERAS plans are useful. They’ve noticed fewer problems after surgery, patients needing fewer strong painkillers, and cost savings. Some other cool things they noticed were shorter hospital stays and happier patients. But, not everything’s easy – some surgeons said it’s tough to get everyone on board with these new plans, especially because hospitals are set in their ways and tech systems can be stubborn. Most surgeons, though, seem to be happy with ERAS and want to make it even better in the future.
Conclusion: The study showed that about half of the neurosurgeons use this method, whether they work in teaching hospitals or private clinics. However, there’s no one-size-fits-all guideline for using ERAS, and getting everyone to adopt it has been tough.
Implications: To make more surgeons use ERAS, teamwork is crucial. Everyone, from the surgeon to the nurses, must be on board. And while some hospitals are sharing their successful ERAS plans with others, what is needed is a national set of guidelines backed by strong research to make this method a standard everywhere.
The complete study can be found in the Journal of Clinical Neuroscience.
Citation:
Agarwal P, Frid I, Singer J, et al. Neurosurgery perception of Enhanced Recovery After Surgery (ERAS) protocols. J Clin Neurosci. 2021;92:110-114. doi:10.1016/j.jocn.2021.07.044
