Effect of Enhanced Recovery After Surgery Protocol on Postoperative Outcomes Following Elective Abdominal Surgery

Introduction: Enhanced Recovery After Surgery (ERAS) is a multimodal perioperative pathway aimed at mitigating surgical stress and ensuring fast functional recovery. The purpose of the current research is to analyze postoperative recovery outcomes of patients who had undergone elective abdominal surgery under ERAS versus conventional perioperative care. Materials and Methods: This prospective comparative study was conducted in the Department of General Surgery, Sanjay Gandhi Memorial Hospital, Delhi, India, over 12 months. Fifty patients who had undergone elective abdominal surgery were randomly divided into two groups: ERAS (n=25) and conventional-care (n=25). Outcomes were measured in terms of postoperative pain, opioid consumption, time to oral intake, mobilization, first flatus, bowel movement, postoperative complications, length of hospital stay, 30-day readmission and reoperation rates. Continuous variables were analyzed using independent t-test, whereas categorical variables by Chi-square or Fisher's exact test (p<0.05). Results: Demographic and clinical characteristics of patients in both groups were similar. ERAS group showed significantly earlier oral intake (8.6 ± 2.1 vs. 18.4 ± 4.2 hours), mobilization (9.8 ± 2.6 vs. 21.6 ± 5.1 hours), first postoperative flatus (27.4 ± 7.2 vs. 43.8 ± 10.6 hours), and first bowel movement (43.2 ± 10.8 vs. 62.6 ± 14.7 hours; all p<0.001). Postoperative pain scores and opioid requirements were lower in the ERAS group. Mean length of hospital stay was lower (4.2 ± 1.1 vs. 6.8 ± 1.7 days; p<0.001). Postoperative complications occurred in fewer patients in the ERAS group (24.0% vs. 48.0%), but the difference was not statistically significant (p=0.077). Readmission and reoperation rates within 30 days did not differ between groups. Conclusion: ERAS implementation resulted in fastened postoperative functional recovery, decreased pain and opioid consumption, earlier recovery of gastrointestinal function, and shorter hospital stay in patients with elective abdominal surgery. No increase in readmission and reoperation was observed.