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Structured Motor Rehabilitation After Selective Nerve Transfers
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Enhanced recovery after neurosurgery.

Robert Canelli1, Paul Karim1, Federico Bilotta2

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Enhanced recovery after surgery (ERAS) protocols are underutilized in neurosurgery but show promise. Implementing ERAS for brain and spine surgeries can reduce complications and costs, despite adoption challenges.

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ERAS for brain surgeryERAS for spine surgeryenhanced recovery protocol

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Area of Science:

  • Neurosurgery
  • Perioperative Care
  • Evidence-Based Medicine

Background:

  • Enhanced Recovery After Surgery (ERAS) optimizes perioperative care but adoption in neurosurgery is limited.
  • Neurosurgical specialties have been slow to implement ERAS protocols compared to other surgical fields.

Purpose of the Study:

  • To review recently published ERAS protocols for elective neurosurgical procedures, focusing on brain and spine surgeries.
  • To assess the current state and potential of ERAS in neurosurgery.

Main Methods:

  • Systematic review of published ERAS protocols for neurosurgical procedures.
  • Analysis of ERAS elements specific to brain and spine surgeries.

Main Results:

  • Few ERAS protocols exist for neurosurgery compared to other specialties.
  • Key ERAS elements for brain surgery include thromboprophylaxis, antiepileptic management, steroid use, blood pressure control, and avoiding mannitol.
  • Implemented ERAS protocols show reduced morbidity, shorter hospital stays, and lower costs, similar to other specialties.

Conclusions:

  • ERAS adoption in neurosurgery is limited but feasible and effective.
  • Emerging evidence suggests ERAS can decrease hospitalization costs and postoperative complications in neurosurgery.