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Roslan, Farah; Balsom, Stephanie; Rajangam, Akshaya; Evans, John; Ihedioha, Ugo

EP.WE.467A Snapshot Audit on the Compliance of Postoperative ERAS Protocol Following the Resumption of Elective Colorectal Surgical Operations in the COVID-19 era

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  • Media type: E-Article
  • Title: EP.WE.467A Snapshot Audit on the Compliance of Postoperative ERAS Protocol Following the Resumption of Elective Colorectal Surgical Operations in the COVID-19 era
  • Contributor: Roslan, Farah; Balsom, Stephanie; Rajangam, Akshaya; Evans, John; Ihedioha, Ugo
  • imprint: Oxford University Press (OUP), 2021
  • Published in: British Journal of Surgery
  • Language: English
  • DOI: 10.1093/bjs/znab308.056
  • ISSN: 0007-1323; 1365-2168
  • Keywords: Surgery
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Aim</jats:title> <jats:p>The COVID-19 pandemic has put a pause on most elective surgical procedures nationally. Although the efficacy of ERAS protocol has been well established, its compliance following the resumption of elective services is unknown. Our study aims to assess the level of adherence in the postoperative arm of ERAS in a large district general hospital (DGH).</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Patients who underwent elective colorectal surgery were audited prospectively between 1st September 2020 and 15th October 2020.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>The mean age (SD) of the 23 patients audited [11(48%) male] was 65 (16) years. Of the cases audited, 17 (74%) had malignant pathology and 6 (26%) were benign. The overall mean compliance score was 4.91 out of 7 (70%). Nasogastric tube was not used in most patients [22(96%)]. However, compliance was poor with regards to opioid avoidance [2(8%)]. Majority of cases complied with early discontinuation of intravenous fluids administration and catheter removal, 14 (61%) and 13 (57%) respectively. 18 patients (78%) resumed oral intake by the first day after surgery and 21 patients (91%) mobilised by the third postoperative day. Higher compliance was significantly associated with decreased length of stay (p = 0.01) but did not reveal significant association with 30-day morbidity.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Although the compliance to postoperative ERAS protocol is generally good, our study highlighted a strong need to improve the postoperative practice of opioid avoidance. Stricter adherence should be aimed for as it is associated with shorter hospital stay which is particularly important in the COVID-19 pandemic era.</jats:p> </jats:sec>