Spanish survey on enhanced recovery after surgery

Area of Science:

• Perioperative Medicine
• Surgical Protocols
• Clinical Practice Guidelines

Background:

• Enhanced Recovery After Surgery (ERAS) protocols are increasingly adopted in perioperative care.
• Understanding clinician familiarity and application of ERAS is crucial for optimizing patient outcomes.

Purpose of the Study:

• To assess the awareness and implementation of ERAS protocols among healthcare professionals in Spain.
• To identify the extent of adherence to ERAS and GERM (ERAS Spain) recommendations.
• To gauge interest in developing national multidisciplinary guidelines for ERAS.

Main Methods:

• A cross-sectional survey was distributed online via professional society websites (Anesthesiology, Surgery, Nutrition) from September to December 2014.
• The survey targeted clinicians across Spain to gather data on ERAS protocol knowledge and practice.

Main Results:

• 272 professionals responded, with 73% having ERAS experience and 86.1% possessing specific knowledge.
• While ERAS protocols are used in 73.1% of hospitals (primarily colorectal surgery), only 52.2% follow recommendations.
• Perioperative nutritional assessment was poor (46.6%), though elements like mobilization (90.1%) and early feeding (87.9%) were commonly implemented. Postoperative nausea/vomiting and ileus were key reasons for protocol failure.

Conclusions:

• Spanish clinicians demonstrate familiarity with ERAS protocols, but a lack of consensus and adherence to existing guidelines is evident.
• Hospital compliance with ERAS recommendations is suboptimal, particularly concerning perioperative nutritional management.
• There is strong support (95.5%) for the development of national, multidisciplinary ERAS guidelines.