Enhanced Recovery After Craniotomy: Global Practices, Challenges, and Perspectives

Area of Science:

• Neurosurgery
• Surgical Recovery
• Healthcare Management

Background:

• Global demand for hospital care necessitates optimized resource management.
• Enhanced Recovery After Surgery (ERAS) protocols improve patient recovery and reduce costs but are not fully adopted in neurosurgery, specifically craniotomy.
• ERAS for craniotomy shows potential for reduced hospital stay, costs, postoperative nausea, and opioid use.

Purpose of the Study:

• To explore the global landscape of ERAS for craniotomy.
• To assess existing literature and identify knowledge gaps in ERAS for craniotomy.
• To provide a comprehensive global overview of ERAS protocol applications, challenges, and future perspectives.

Main Methods:

• A narrative review of current literature on ERAS for craniotomy.
• Inclusion of expert insights from 26 countries across all 6 World Health Organization geographical areas.
• Analysis of implementation barriers and tailored strategies for diverse healthcare systems.

Main Results:

• ERAS for craniotomy is underutilized globally, with limited standardized guidelines.
• Key implementation barriers include lack of standardized protocols, provider resistance, resource constraints, insufficient education, and research scarcity.
• Experts highlighted the need for adaptable ERAS protocols, particularly for low and middle-income countries.

Conclusions:

• Adaptable ERAS protocols are crucial for craniotomy, considering diverse global healthcare systems and resource availability.
• Addressing implementation challenges is essential for wider adoption of ERAS in craniotomy worldwide.
• Further research and standardized guidelines are needed to optimize ERAS for craniotomy globally.