From home to hospital and home again, every patient hopes for a smooth journey. Even if all goes well clinically, however, in a traditional recovery scenario, healing may be delayed or impeded for a number of reasons.
Thanks to a perceptive colorectal surgeon from Denmark, however, a new system may be able to help orthopedic surgeons refine their clinical signposts and deliver faster, better, indeed, enhanced recovery after surgery.
In fact, the system is called Enhanced Recovery After Surgery…ERAS.
Ellen M. Soffin, M.D., Ph.D., assistant attending anesthesiologist at Hospital for Special Surgery (HSS) in New York and the lead anesthesiologist on a multidisciplinary team applying ERAS principles to spine surgery, received a $25,000 grant from the HSS Spine Service Research Fund to bring the ERAS approach to spine surgery.
Dr. Soffin told OTW, “In the mid-1990s Professor Henrik Kehlet, Ph.D., M.D., from the University of Copenhagen and winner of the 2014 Excellence in Research award from the American Society of Anesthesiologists, began asking, ‘Why is it that with all of the knowledge we have about interventions that positively affect outcomes, that patients receive different care and have different complications after getting the same procedures in different facilities?’”
“One part of Professor Kehlet’s solution was to take the best available evidence for all interventions that contribute to a good outcome, bundle them into a standardized package of care, and deliver that package to the patient, thus ensuring the delivery of top-of-the-line care. You’re basically bundling the benefits of a systems approach so that you can track what you’ve done and examine the outcomes.”
Todd Albert, M.D., surgeon-in-chief, chief medical officer and Korein-Wilson Professor of Orthopedic Surgery at HSS, said, “ERAS has proven itself to be beneficial in a number of surgical subspecialties, resulting in improved outcomes and patient satisfaction, as well as reduced length of stay (LOS) and complications.”
“The ERAS principles have yet to be applied to spine surgery. HSS’s Sheeraz Qureshi, M.D., M.B.A. and I are co-authors of two studies on ERAS, one involving minimally invasive surgery (MIS) lumbar decompression and another on anterior cervical surgery.”
“Our team developed a 15-item ERAS protocol for lumbar decompression that includes a range of pre-, intra- and postoperative components, including pre-emptive analgesia, standardized intraoperative anesthesia, minimally invasive surgical techniques, and postoperative physical therapy and opioid-sparing analgesia.”
