Effectiveness of enhanced recovery after surgery protocol in major gynecological surgeries: a cross-sectional study

Background: Objectives of the study include: assessment of effectiveness of perioperative outcome of components of enhanced recovery after surgery protocol (ERAS-P) - pre-operative, intra-operative, post-operative and compliance of participants to ERAS-P. Methods: A prospective cross sectional study was conducted at Sri Chamarajendra Government, Teaching MCH hospital in one year.80women fulfilling selection criteria were selected for elective major gynecological surgeries under ERAS-P. Components of ERAS-P include: pre-operative, intra-operative, and post-operative were practiced and the outcomes include the length of hospital stay, post-operative pain assessment, return of bowel function, admission to discharge interval, cost of treatment, complications, repeat hospitalization, and patient satisfaction rate were assessed. Results: Among 80 participants, distribution of cases were- abnormal uterine bleeding (AUB-L) leiomyoma-37.5%, uterine prolapsed-32.5%, adnexal mass-8.8%, adenomyosis-in 7.5%, and others 5%. The average length of hospital stay was 24 hours for laparoscopic salpingectomy, 48 hours for laparoscopic surgery, 72 to 96 hours for vaginal hysterectomy and laparoscopic surgery and 96 hours for TAH±BSO. The visual analogue scores indicated pain levels among participants with the mean score at 6 hours’ post-surgery-5.51 for major surgeries and <4.00 for minimal invasive surgeries. Conclusions: The implementation of ERAS-P is observed to be associated with reduction in duration of hospitalization, early mobilization, need based pain management, high satisfaction, lower complications, and repeat hospitalization.