Abstract
Purpose
Enhanced Recovery After Surgery (ERAS) protocols have been demonstrated to expedite
recovery and decrease hospital stay from multiple surgical specialties. This study
sought to determine how an ERAS protocol would improve patient outcomes with regards
to inpatient postoperative nausea, vomiting, and pain scores following orthognathic
surgeries.
Methods
This was a retrospective study comparing patients who underwent orthognathic surgery
with and without an ERAS protocol. The primary measurables include opioid consumption,
antiemetic medical consumption, nausea and vomiting incidences, and pain scores between
the two groups during their hospital stays.
Results
A total of 56 patients were retrospectively analyzed comparing ERAS protocol to non-ERAS
protocol. The maximum pain scores of the ERAS group was 5.50 out of 10 compared to
the control group of 7.50 out of 10 (p<.001). Morphine equivalent consumption during
their time in the ward was statistically significant (51.4 mg control versus 9.4 mg
ERAS group).
Conclusion
ERAS protocol is safe and effective for decreasing post-operative pain and nausea.
The ERAS protocol is not only applicable for orthognathic surgery but should be highly
considered for other maxillofacial surgeries.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to British Journal of Oral and Maxillofacial SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on measurement to maintain and improve quality of enhanced recovery pathways for elective colorectal surgery.Perioper Med (Lond). 2017; 6: 6
- Enhanced recovery after surgery (ERAS) program for lumbar spine fusion.Periooperative Medicine. 2019; 8: 4
- Management of postoperative nausea and vomiting in the context of an Enhanced Reocvery after Surgery program. Best Practice & Research Clinical.Anesthesiology. 2020; 34: 687-700
- Improved analgesia and reduced post-operative nausea and vomiting after implementation of enchanced recovery after surgery (ERAS) pathway for total mastectomy.BMC Anesthesiology. 2018; 18: 41
- A Challenging Problem That Concerns the Aesthetic Surgeon: Postoperative Nausea and Vomiting.Ann Plast Surg. 2008; 61: 489-491
- Preparing the Patient for Enhanced Recovery After Surgery.Int Aneshtesiol Clin. 2017; 55: 12-20
- Optimal Preioperative Care in Major Head and Neck Cancer Surgery With Free Flap Reconstruction: A Consensus Review and Recommendations From the Enhanced Recovery After Surgery Society.JAMA Otolaryngol Head Neck Surg. 2017; 143: 292-303
- Enhanced recovery in patients having free tissue transfer for head and neck cancer: does it make a difference?.Br J Oral Maxillofac Surg. 2017; 55: 1024-1029
- Enhanced Recovery After Surgery Protocol (ERAS) for Same-Day Discharge and Reduction of Opioid Use Following Bimaxillary Orthognathic Surgery.J Oral Maxillofac Surg. 2022; 80: 38-46
- Benefits of the enhanced recovery after surgery pathway for orthognathic surgery.Int J Oral Maxillofac Surg. 2022 Feb; 51: 212-218
- The Effect of Gabapentin on Postoperative Pain, Morphine Sparing Effect and Preoperative Anxiety in Patients Going for Sleeve Gastrectomy Surgical Procedure.J Coll Physicians Surg Pak. 2018; 29: 697-701
- Effect of Perioperative Gabapentin on Postoperative Pain Resolution and Opioid Cessation in a Mixed Surgical Cohort: A Randomized Clinical Trial.JAMA Surg. 2018; 153: 303-339
- Preoperative multimodal analgesia decreases 24-hour postoperative narcotic consumption in elective spinal fusion patients.J Spine. 2019; 19: 1753-1763
- Effects of Addition of Preoperative Intravenous Ibuprofen to Pregabalin on Postopertive Pain in Posterior Lumbar Interbody Fusion Surgery.Pain Res Mang. 2017; : 6
- Effect of Perioperative Gabapentin Use on Postsurgical Pain in Patients Udneroging Head and Neck Mucosal Surgery: A Randomized Clinical Trial.JAMA Otolaryngol Head Neck Surg. 2018; 144: 959-966
- Preoperative Gabapentin Administration Improves Acute Postoperative Analgesia in Patients Undergoing Craniotomy: A Randomized Clinical Trial.J Neuro Surg Anesthesiol. 2019; 31: 392-398
- Assessment of Common Nonsteroidal Anti-inflammatory Medications by Whole Blood Aggregometry: A Clinical Evaluation for the Perioperative Setting.World Neurosurg. 2014; 82: e633-e638
- Unexpected hemorrhage complications in association with celecoxib: Spontaneously reported case series after perioperative pain treatment in gynecological operations.Anaesthesist. 2014; 63: 958-960
- Decreasing Opioid Usage during Hospitalization in Patients Undergoing Orthognathic Surgery.J Oral Maxillofac Surg. 2020; 10: e6-e7
- Postoperative pain management using supplemental bupivacaine after mandibular orthognathic surgery: a triple-blind randomized controlled clinical trial.J Oral Maxillofac Surg. 2021; 8
- Review of Preoperative Carbohydrate Loading.Nutr Clin Pract. 2015; 30: 660-664
- How Much Weight Loss Can Be Expected After Treating Mandibular Fractures?.J Oral Maxillofac Surg. 2019; 77: 777-782
Article info
Publication history
Accepted:
January 13,
2023
Publication stage
In Press Accepted ManuscriptFootnotes
☆“The views expressed in this article reflect the results of research conducted by the author and do not necessarily reflect the official policy or position of the Defense Health Agency, the Department of the Army, the Department of the Air Force, the Department of the Navy, Department of Defense, nor the United States Government.” “All authors are military service members of the United States government. This work was prepared as part of my official duties. Title 17 U.S.C. 105 provides that `copyright protection under this title is not available for any work of the United States Government.' Title 17 U.S.C. 101 defines a U.S. Government work as work prepared by a military service member or employee of the U.S. Government as part of that person's official duties.” “All authors are military service members of the United States government. This work was prepared as part of my official duties. Title 17 U.S.C. 105 provides that `copyright protection under this title is not available for any work of the United States Government.' Title 17 U.S.C. 101 defines a U.S. Government work as work prepared by a military service member or employee of the U.S. Government as part of that person's official duties.”
Identification
Copyright
Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons.
