Evaluation of Enhanced Recovery After Surgery (ERAS) Components in Hemodynamically Stable Subjects Undergoing Emergency Abdominal Surgery in VMKVMCH
DOI:
https://doi.org/10.52783/jns.v14.2194Keywords:
Enhanced Recovery after Surgery,, Emergency laparotomy, EvaluationAbstract
Introduction and Objectives- Intestinal obstructions and perforations are common acute abdominal conditions seen in our emergency department, carrying significant risks if not promptly treated. Implementing Enhanced Recovery After Surgery (ERAS) protocols in this context offers potential for reducing surgical stress response. To study on the evaluation of ERAS components in hemodynamically stable subjects undertaking Emergency abdominal surgery in a 30 care hospital.
Methodology: The study was a descriptive study done among 30 subjects with the main objective to study on the evaluation of ERAS components in hemodynamically stable subjects undertaking Emergency abdominal surgery in a 30 care hospital. The study included haemodynamically stable subjects requiring emergency abdominal surgeries and National Early Warning Score (NEWS) scoring-Mild to moderate. Subjects with elective gastrointestinal surgeries, haemodynamically unstable patient, Subjects not willing for surgery and NEWS scoring high risk- aggregate score>7. The subjects were assessed with preoperative, intraoperative and post operative ERAS protocols. The data was inputted into Microsoft Excel and analyzed utilizing SPSS 23.
Results: All the subjects had Patient, Family Education and Shared Decision, early imaging, anti-microbial prophylaxis, preoperative pain medication, nasogastric intubation, open surgical access, goal directed fluid therapy, warm IV fluids, non-opioid analgesia, received Ondansetron 4 mg iv as Post Operative Nausea and Vomiting(PONV), Post- Operative Analgesia, Thromboprophylaxis, Net Zero Fluid And Electrolyte Balance, Glycaemic Control and Sham Feeding. Among the subjects, 27 (90%) had quick Sequential Organ Failure Assessment (qSOFA) score 1 and 3 (10%) had qSOFA score 2. Among the subjects, 29 (96.67%) had score 0 and 1 (3.33%) had score 1.5 as Modified Wells Score for Venous Thrombo-embolism. Among the subjects, 6 (20%) received Fresh Frozen Plasma (FFP) Transfusion and remaining 24 (80%) received no anti thrombotic medication.
Conclusion: This study showed a significant alteration in management on the basis of preoperative, intraoperative and postoperative protocols by ERAS. When applied to trauma laparotomy, which involves surgical exploration of the abdomen due to traumatic injuries, implementing ERAS protocols has been demonstrated to have beneficial effects
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