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. 2024 Feb 14;8(4):427-432.
doi: 10.22603/ssrr.2023-0193. eCollection 2024 Jul 27.

Adoption of an Enhanced Recovery after Surgery Protocol for Neuromuscular Scoliosis Shortens Length of Hospital Stay

Naoyuki Nakamura  1 , Yuichiro Kawabe  1 , Takako Momose  1 , Masatoshi Oba  1 , Kouji Yamamoto  2 , Tetsuya Takamasu  3 , Mayuko Suzuki  4 , Nobuto Nakamura  5 , Miki Koba  6
Affiliations

Adoption of an Enhanced Recovery after Surgery Protocol for Neuromuscular Scoliosis Shortens Length of Hospital Stay

Naoyuki Nakamura et al. Spine Surg Relat Res. .

Abstract

Introduction: We aimed to implement the enhanced recovery after surgery (ERAS) protocol for pediatric neuromuscular scoliosis (NMS) surgery and to examine the effectiveness of this program in this study.

Methods: Subjects were children with NMS who underwent scoliosis surgery at our department by a surgeon using a single posterior approach. A series of 27 cases before the introduction of ERAS and 27 cases during program stabilization were included in the study. Patient backgrounds did not show significant differences before and after introducing ERAS. Perioperative data, complications, length of hospital stay (LOS), and readmission within 90 days were investigated and statistically analyzed.

Results: When the pre- and post-ERAS induction groups were compared, no significant differences in anesthesia induction time (p=0.979), pelvic fixation (p=0.586), fusion levels (p=0.479), intraoperative hypothermia duration (p=0.154), end-of-surgery body temperature (p=0.197), operative time (p=0.18), postoperative main Cobb angle (p=0.959), main Cobb angle correction rate (p=0.91), postoperative spino-pelvic obliquity (SPO) (p=0.849), and SPO correction rate (p=0.267) were observed. However, significant differences in using V-flap technique (p=0.041), intraoperative blood loss (p=0.001), and LOS (p=0.001) were observed. Intraoperative blood loss was weakly correlated with LOS (p=0.432 and 0.001). No statistically significant difference existed between the V-flap method and LOS (p=0.265). Multiple regression analysis using LOS as the objective variable and ERAS protocols and intraoperative blood loss as explanatory variables revealed that the effect of ERAS on LOS was greater than that of intraoperative blood loss. No statistically significant differences in the readmission rates within 90 days were found.

Conclusions: After the introduction of ERAS, LOS decreased without an increase in complications or readmissions within 90 days.

Keywords: complication; enhanced recovery after surgery (ERAS); length of hospital stay (LOS); neuromuscular scoliosis; pediatric; surgery.

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Conflict of interest statement

Conflicts of Interest: The authors declare that there are no relevant conflicts of interest.

Figures

Figure 1.
Figure 1.
LOS; pre- and post-ERAS protocols. LOS in patients treated for neuromuscular scoliosis before and after the implementation of ERAS protocols. ERAS, enhanced recovery after surgery LOS, length of hospital stay
See this image and copyright information in PMC

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