Implementation of an Enhanced Recovery Pathway for Pediatric Single Lobe Thyroidectomy

Area of Science:

• Pediatric Surgery
• Anesthesiology
• Perioperative Medicine

Background:

• Enhanced Recovery Pathways (ERP) optimize perioperative care in adults but are less common in pediatric populations.
• Pediatric thyroid surgery lacks established ERP protocols, necessitating research into their feasibility and effectiveness.

Purpose of the Study:

• To determine the feasibility and effectiveness of a pediatric-specific Enhanced Recovery Pathway (ERP) for single-lobe thyroidectomy.
• To evaluate outcomes including pain, nausea, discharge time, and patient satisfaction.

Main Methods:

• A prospective study of 16 pediatric patients (8+ years) undergoing single-lobe thyroidectomy.
• Implementation of a standardized ERP including preoperative, intraoperative, and postoperative care.
• Outcome measures: pain, nausea, discharge time, satisfaction; data analyzed using descriptive statistics.

Main Results:

• High ERP adherence (100%) with a 93.8% same-day discharge rate.
• Effective pain management (68.8% opioid-free) and high patient satisfaction (5/5 mean score).
• No intraoperative or postoperative complications, and no readmissions were reported.

Conclusions:

• A pediatric ERP for single-lobe thyroidectomy is feasible and effective.
• This approach facilitates same-day discharge, opioid-sparing pain control, and high patient satisfaction.
• ERPs can be safely adapted for pediatric thyroid surgery, potentially improving perioperative care standards.