Current perioperative practice in Canadian vascular surgery

Area of Science:

• Perioperative Medicine
• Vascular Surgery

Background:

• The Enhanced Recovery After Surgery (ERAS) Society promotes evidence-based perioperative practices for improved patient recovery.
• ERAS principles are widely adopted but primarily focus on general surgery, with less clarity on their application in vascular surgery.

Purpose of the Study:

• To investigate the current perioperative care standards in Canadian vascular surgery.
• To assess surgeons' perceptions of ERAS evidence and identify barriers to implementation.
• To identify areas needing vascular surgery-specific research for improved perioperative care.

Main Methods:

• An online survey with 26 questions was distributed to all members of the Canadian Society for Vascular Surgery.

Main Results:

• Significant variation exists in Canadian vascular surgery perioperative practices, particularly regarding nasogastric tubes, Foley catheters, and neck drains.
• Surgeons demonstrated poor familiarity with evidence supporting ERAS, with many citing institutional barriers or a lack of relevant evidence.
• 44% of respondents were unaware of contrary evidence, and 30% believed no relevant evidence existed to support practice changes.

Conclusions:

• Variability in Canadian vascular surgery perioperative practices stems from multiple factors, including a lack of specific evidence.
• Targeted research in areas of significant practice variation within perioperative vascular care is recommended.
• Such research may enhance recovery after vascular surgery in Canada more effectively than simply adopting existing ERAS principles.