Investigation of the application of Enhanced Recovery After Surgery (ERAS) in elderly patients undergoing surgery for kidney stones

Abstract

Objective: To investigate the efficacy and application of Enhanced Recovery After Surgery (ERAS) in elderly patients undergoing surgery for kidney stones.

Methods: Clinical data of 104 elderly patients who underwent kidney stone surgery at West China Hospital, Sichuan University from January 2020 to December 2022 were retrospectively analyzed in this study. The patients were divided into two groups according to different nursing plans. Among them, 52 patients in the control group received conventional nursing, and 52 patients in the study group received ERAS mode nursing. Postoperative recovery, anxiety, complications, stress response and quality of life were compared between the two groups.

Results: The time to recovery of postoperative rehabilitation indices in the research group was significantly shorter compared to the control group (P < 0.05). The research group also exhibited a significantly lower incidence of complications such as hematuria, abdominal pain, vomiting, chills, fever, and hypotension (all P < 0.05). Before the initiation of nursing care, there were no significant differences in the State Anxiety Inventory (SAI) and Trait Anxiety Inventory (TAI) scores between the two groups (both P > 0.05). However, after nursing care, the research group exhibited lower SAI and TAI scores compared to the control group (all P < 0.05). Similarly, there was no significant difference in the General Quality of Life Inventory-74 (GQOLI-74) scores in any dimension between the two groups before nursing care (P > 0.05), but the research group showcased higher scores in every dimension after nursing care (P < 0.05). The levels of Heme Oxygenase-1 (HO-1), Endothelin-1 (ET-1), Adrenocorticotropic Hormone (ACTH), and Cortisol (Cor) were significantly lower in the research group after nursing care (all P < 0.05). The acknowledgment and approval scores of nursing care in the research group were higher than those in the control group (P < 0.05).

Conclusion: The application of ERAS in elderly patients with kidney stones undergoing transurethral ureteral holmium laser lithotripsy is efficacious in mitigating stress reactions, enhancing quality of life and reducing perioperative anxiety, minimizing the incidence of complications, and promoting overall patient recovery.

Keywords: Elderly; Enhanced Recovery After Surgery; kidney stone; nursing; surgery.

Figure 1

Comparison of perioperative recovery time of each index between the two groups. A: Operation time; B: Intraoperative bleeding; C: Bowel sound recovery time; D: Postoperative anal exhaust time; E: Catheter retention time; F: Postoperative first feeding time. *, P < 0.05.

Figure 2

Comparison of patients’ SAI and TAI scores between two groups. A: SAI; B: TAI. Note: *, P < 0.05, comparison between the two groups. #, P < 0.05, comparison between pre- and post-care within groups. SAI: State Anxiety Inventory; TAI: Trait Anxiety Inventory.

Figure 3

Comparison of GQOLI-74 scores of patients before and after care between the two groups. A: Physical function; B: Psychological function; C: Social function; D: Material life status. *, P < 0.05. GQOLI-74: General Quality of Life Inventory-74.

Figure 4

Comparison of HO-1, ET-1, ACTH, and Cor levels between the two groups of patients after nursing care. HO-1: hemoglobin oxygenase-1; ET-1: endothelin-1; ACTH: adrenocorticotropic hormone; Cor: cortisol. *, P < 0.05.