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Enhanced recovery after elective craniotomy: A randomized controlled trial.

Lei Wang¹, Hongwei Cai¹, Yanjin Wang²

¹Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, China.

Journal of Clinical Anesthesia

|November 5, 2021

Summary

Enhanced recovery after surgery (ERAS) protocols significantly reduced length of stay and costs for elective craniotomy patients. This neurosurgical ERAS protocol also decreased complications and improved patient recovery.

Keywords:

Enhanced recovery after surgery Neurosurgical anesthesia Outcomes Perioperative care Postoperative length of stay

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Area of Science:

Neurosurgery
Perioperative Care
Evidence-Based Medicine

Background:

Enhanced Recovery After Surgery (ERAS) protocols improve surgical outcomes but are underutilized in neurosurgery.
Elective craniotomy patients can benefit from optimized perioperative management.

Purpose of the Study:

To design a multidisciplinary ERAS protocol for elective craniotomy.
To evaluate the clinical efficacy and safety of this neurosurgical ERAS protocol.

Main Methods:

A prospective randomized controlled trial (RCT) involving 151 patients undergoing elective craniotomy.
Comparison between the neurosurgical ERAS group and a control group receiving routine care.

Main Results:

The ERAS protocol significantly reduced postoperative length of stay (4 to 3 days) and hospitalization costs (USD 6266 to USD 5880).
Reduced incidence of postoperative nausea and vomiting (28.0% to 9.2%), earlier urinary catheter removal, improved ambulation on POD 1, and faster oral intake were observed.

Conclusions:

Implementation of the ERAS protocol for elective craniotomy demonstrated significant benefits over conventional care.
The protocol led to reduced length of stay, lower medical costs, and fewer postoperative complications.