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Enhanced Recovery After Cleft Palate Surgery: Protocol Development and Implementation in Outreach Settings.

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A modified Enhanced Recovery After Surgery (ERAS) protocol effectively reduced complications and hospital stays for pediatric cleft palate (CP) patients in outreach settings. This approach also decreased opioid use while ensuring adequate pain control and promoting faster recovery.

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ERAS protocolOutreach Medical Programcleft palateoutreach setting

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Area of Science:

  • Pediatric Surgery
  • Anesthesiology
  • Public Health

Background:

  • Cleft palate (CP) repair is a common pediatric surgical procedure.
  • Enhanced Recovery After Surgery (ERAS) protocols optimize patient outcomes and reduce hospital stays.
  • Resource-limited settings present unique challenges for implementing surgical recovery protocols.

Purpose of the Study:

  • To describe and demonstrate the effectiveness of a modified ERAS protocol for pediatric cleft palate (CP) patients.
  • To evaluate the reproducibility of this modified ERAS protocol in outreach medical programs.
  • To assess key outcomes including complication rates, pain management, and time to discharge.

Main Methods:

  • Prospective cohort study involving pediatric patients undergoing CP repair.
  • Implementation of a modified ERAS protocol in resource-limited outreach settings.
  • Data collection on complication rates, post-operative pain management strategies, and discharge timelines.

Main Results:

  • 52 CP repairs were analyzed across three outreach programs.
  • A low overall complication rate of 5.8% was reported.
  • 51 out of 52 patients were discharged on post-operative day one, with effective pain management and minimal opioid requirements.

Conclusions:

  • A modified ERAS protocol is feasible and effective for CP surgery in outreach settings.
  • The protocol led to decreased post-operative complications, shorter hospital stays, and reduced opioid consumption.
  • This approach successfully enhanced patient recovery by maintaining adequate pain control and facilitating early enteral feeding.