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

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.