Improving Postoperative Acute Pain Management and Accelerating Discharge: The Role of the ERAS Pathway in Overweight...

Enhanced Recovery After Surgery (ERAS) protocols have increasingly been adopted in gynecologic oncology. This study evaluates their effectiveness in patients undergoing endometrial cancer surgery, focusing on length of hospital stay (LOS), postoperative pain, and complications. A retrospective case-control study was conducted on patients treated between January 2019 and December 2024. Fifty patients managed with ERAS (Group 1) were compared with fifty patients treated with traditional care (Group 2). Groups were matched considering the American Society of Anesthesiologists physical status (ASA-PS) score, International Federation of Gynecology and Obstetrics (FIGO) stage, surgical approach, and age. Key outcomes analyzed were LOS, postoperative pain, analgesic use, and complications. Patients in the ERAS group had a significantly shorter length of stay (LOS) (p < .001), lower pain scores on the numeric rating scale (NRS) at 8, 16, 32, and 48 hours (p < .01-.001), but not at 40 hours (p = .13) at rest, and required fewer opioids (p < 0.001). Additionally, they experienced fewer nausea/vomiting episodes (p = .05). ERAS implementation in endometrial cancer surgery appears to improve recovery, reduce opioid use, and shorten hospitalization without compromising safety. These findings may support ERAS for optimizing perioperative outcomes, especially in overweight patients undergoing endometrial cancer surgery.