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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
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The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
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Updated: May 23, 2025

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Improved Post-Operative Outcomes and Reduced Narcotic Use With ERAS Protocol in a Pediatric Ambulatory Surgery

Niharika Singh1, Jane Ahn2, Xin Chen2

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Paediatric & Neonatal Pain
|March 11, 2025
PubMed
Summary

Implementing enhanced recovery after surgery (ERAS) protocols in pediatric urology significantly increased opioid-free care and improved pain management. This approach enhanced patient outcomes without increasing adverse events or the need for rescue pain medication.

Keywords:
ERASambulatory surgerynarcotic usepediatric surgery

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Area of Science:

  • Pediatric Surgery
  • Anesthesiology
  • Urology

Background:

  • Enhanced Recovery After Surgery (ERAS) protocols are underutilized in pediatric populations compared to adults.
  • Standardized ERAS protocols are needed to improve outcomes in pediatric ambulatory surgery.

Purpose of the Study:

  • To evaluate the impact of an ERAS protocol on patient outcomes in ambulatory pediatric urologic surgery.
  • To compare outcomes between pediatric patients receiving standard care versus an ERAS protocol.

Main Methods:

  • Retrospective analysis of pediatric patients undergoing urologic procedures (circumcision, orchiopexy, hypospadias correction, urethroplasty).
  • Comparison of outcomes including opioid use, home pain control, recovery time, rescue pain medication needs, and adverse events.
  • Two groups: standard of care (n=30) and ERAS protocol (n=29).

Main Results:

  • ERAS protocol significantly increased opioid-free care (7% vs. 43%, p<0.01).
  • ERAS patients reported 100% well-controlled home pain, with trends toward reduced opioid use and PACU stays.
  • No increase in rescue pain medication or adverse events in the ERAS group (p=1.0).

Conclusions:

  • ERAS protocols improve postoperative pain management and outcomes in pediatric ambulatory urologic surgery.
  • The ERAS pathway enhances opioid-free care without compromising safety or increasing adverse events.
  • This study serves as proof of concept for ERAS protocol implementation in pediatric ambulatory surgical settings.