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Review
. 2023 Nov;165(11):3137-3145.
doi: 10.1007/s00701-023-05789-y. Epub 2023 Sep 9.

Implementation of the Enhanced Recovery After Surgery (ERAS®) program in neurosurgery

Amani Belouaer  1 , Giulia Cossu  1 , Georgios E Papadakis  2 , John G Gaudet  3 , Maria-Helena Perez  4 , Vivianne Chanez  4 , Yann Boegli  5 , Caroline Mury  5 , David Peters  1 , Valérie Addor  6 , Marc Levivier  1 , Roy Thomas Daniel  1 , Nicolas Demartines  6 , Mahmoud Messerer  7
Affiliations
Review

Implementation of the Enhanced Recovery After Surgery (ERAS®) program in neurosurgery

Amani Belouaer et al. Acta Neurochir (Wien). 2023 Nov.

Abstract

Background: Over the past decade, Enhanced Recovery After Surgery (ERAS®) guidelines have been proven to simplify postoperative care and improve recovery in several surgical disciplines. The authors set out to create and launch an ERAS® program for cranial neurosurgery that meets official ERAS® Society standards. The authors summarize the successive steps taken to achieve this goal in two specific neurosurgical conditions and describe the challenges they faced.

Methods: Pituitary neuroendocrine tumors (Pit-NET) resected by a transsphenoidal approach and craniosynostosis (Cs) repair were selected as appropriate targets for the implementation of ERAS® program in the Department of Neurosurgery. A multidisciplinary team with experience in managing these pathologies was created. A specialized ERAS® nurse coordinator was hired. An ERAS® certification process was performed involving 4 seminars separated by 3 active phases under the supervision of an ERAS® coach.

Results: The ERAS® Pit-NET team included 8 active members. The ERAS® Cs team included 12 active members. Through the ERAS® certification process, areas for improvement were identified, local protocols were written, and the ERAS® program was implemented. Patient-centered strategies were developed to increase compliance with the ERAS® protocols. A prospective database was designed for ongoing program evaluation. Certification was achieved in 18 months. Direct costs and time requirements are reported.

Conclusion: Successful ERAS® certification requires a committed multidisciplinary team, an ERAS® coach, and a dedicated nurse coordinator.

Keywords: Craniosynostosis; Enhanced Recovery after Surgery (ERAS®); Neurosurgery; Pediatric; Pituitary adenoma; Pituitary neuroendocrine tumors; Transsphenoidal.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Steps to implement ERAS® Program
Fig. 2
Fig. 2
The ERAS® certification process
See this image and copyright information in PMC

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