Effect of enhanced recovery after surgery‑based perioperative nursing on postoperative pain and recovery in patients with cervical cancer: A retrospective cohort study

Patients with cervical cancer undergoing radical hysterectomy frequently experience substantial postoperative pain and delayed recovery. The present study aimed to evaluate the effectiveness of enhanced recovery after surgery (ERAS)-based perioperative nursing care on pain management, functional recovery and complication rates within this population of patients. A retrospective cohort study was conducted involving 327 patients who underwent type II or III radical hysterectomy for cervical cancer between January 2020 and December 2023 at a tertiary academic hospital. Patients were grouped based on the perioperative nursing model received. The ERAS group (n=162) received structured ERAS-based care, while the control group (n=165) received conventional nursing care. Primary outcomes included postoperative pain intensity assessed using the visual analog scale (VAS) at 6, 24 and 48 h. Secondary outcomes included analgesic use, patient satisfaction, recovery milestones, postoperative complications and 30-day readmission. Multivariable linear regression was conducted to identify independent predictors of pain at 24 h. Baseline characteristics were comparable between groups. VAS scores at 6, 24 and 48 h were significantly lower in the ERAS group (all P<0.001). Patients in the ERAS group also had reduced cumulative opioid use, less reliance on patient-controlled analgesia, greater adoption of non-pharmacological analgesia and higher satisfaction with pain control (all P<0.01). Functional recovery was accelerated, with earlier ambulation, oral intake, catheter removal and hospital discharge in the ERAS group (P<0.001). The overall complication rate was lower in the ERAS group compared with the control group (8.0 vs. 17.6%; P=0.009). Multivariate analysis showed that ERAS care (β=-1.05; P<0.001) and non-pharmacological analgesia (β=-0.39; P=0.010) were independently associated with lower pain scores. ERAS-based perioperative nursing significantly improved postoperative pain control, enhanced early recovery and reduced minor complications in patients with cervical cancer undergoing radical surgery. These findings support the implementation of ERAS protocols as a standard component of perioperative nursing care in gynecologic oncology.