Enhanced recovery after spinal surgery protocol versus conventional care in non- insulin diabetic patients: A prospective randomized trial
ABSTRACTBackground Enhanced Recovery After Surgery (ERAS) approach was proven in many surgical specialties. This prospective, randomized, single-blinded trial was designed to assess the effectiveness of ERAS on quality of recovery (QOR) after surgery in non-insulin-dependent diabetic patients.Patien...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2023.2196113 |
| _version_ | 1797859200759496704 |
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| author | Sarah Mohamed Elgamal Ashraf Arafat Abdelhalim Emad Abdelmoneim Arida Abdulrahman Magdy Elhabashy Rania Abo-Elfetouh Sabra |
| author_facet | Sarah Mohamed Elgamal Ashraf Arafat Abdelhalim Emad Abdelmoneim Arida Abdulrahman Magdy Elhabashy Rania Abo-Elfetouh Sabra |
| author_sort | Sarah Mohamed Elgamal |
| collection | DOAJ |
| description | ABSTRACTBackground Enhanced Recovery After Surgery (ERAS) approach was proven in many surgical specialties. This prospective, randomized, single-blinded trial was designed to assess the effectiveness of ERAS on quality of recovery (QOR) after surgery in non-insulin-dependent diabetic patients.Patients and methods 72 patients undergoing elective lumbar decompressive surgery were randomly allocated to one of two equal groups receiving either ERAS protocol in group E or conventional care in group C. QOR after surgery using QOR-40 score, pain score, perioperative opioid consumption, time to early ambulation, serum markers of stress response, length of stay and possible perioperative complications were recorded.Results QOR-40 scores were significantly greater in group E at PACU, first postoperative day and second postoperative day (P = 0.015, 0.041 and 0.048, respectively). VAS was significantly lower in group E in the first eight hours postoperative. Time to first postoperative analgesic requirement was significantly longer in group E (P = 0.0001). Intraoperative fentanyl and postoperative nalbuphine requirements were significantly less in group E (P = 0.001, and 0.0001, respectively). Time to early ambulation was significantly less in group E (P = 0.006). Both CRP and interleukin-6 were significantly less at the second postoperative day in group E (P = 0.001, and 0.017, respectively). There was insignificant difference among groups in length of hospital stay and intraoperative insulin requirements (P = 0.251, and 0.347, respectively).Conclusion In non-insulin diabetic patients, enhanced recovery after spinal surgery improved quality of recovery, lowered pain scores, reduced perioperative opioid consumption, allowed early ambulation and decreased stress response but not length of hospital stay. |
| first_indexed | 2024-04-09T21:25:36Z |
| format | Article |
| id | doaj.art-256b08ab77684e32bf2a3f79411b61ec |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-04-09T21:25:36Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-256b08ab77684e32bf2a3f79411b61ec2023-03-27T13:02:10ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492023-12-0139131332110.1080/11101849.2023.2196113Enhanced recovery after spinal surgery protocol versus conventional care in non- insulin diabetic patients: A prospective randomized trialSarah Mohamed Elgamal0Ashraf Arafat Abdelhalim1Emad Abdelmoneim Arida2Abdulrahman Magdy Elhabashy3Rania Abo-Elfetouh Sabra4Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Alexandria University, Alexandria, EgyptDepartment of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Alexandria University, Alexandria, EgyptDepartment of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Alexandria University, Alexandria, EgyptDepartment of Neurosurgery, Faculty of Medicine, Alexandria University, Alexandria, EgyptDepartment of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Alexandria University, Alexandria, EgyptABSTRACTBackground Enhanced Recovery After Surgery (ERAS) approach was proven in many surgical specialties. This prospective, randomized, single-blinded trial was designed to assess the effectiveness of ERAS on quality of recovery (QOR) after surgery in non-insulin-dependent diabetic patients.Patients and methods 72 patients undergoing elective lumbar decompressive surgery were randomly allocated to one of two equal groups receiving either ERAS protocol in group E or conventional care in group C. QOR after surgery using QOR-40 score, pain score, perioperative opioid consumption, time to early ambulation, serum markers of stress response, length of stay and possible perioperative complications were recorded.Results QOR-40 scores were significantly greater in group E at PACU, first postoperative day and second postoperative day (P = 0.015, 0.041 and 0.048, respectively). VAS was significantly lower in group E in the first eight hours postoperative. Time to first postoperative analgesic requirement was significantly longer in group E (P = 0.0001). Intraoperative fentanyl and postoperative nalbuphine requirements were significantly less in group E (P = 0.001, and 0.0001, respectively). Time to early ambulation was significantly less in group E (P = 0.006). Both CRP and interleukin-6 were significantly less at the second postoperative day in group E (P = 0.001, and 0.017, respectively). There was insignificant difference among groups in length of hospital stay and intraoperative insulin requirements (P = 0.251, and 0.347, respectively).Conclusion In non-insulin diabetic patients, enhanced recovery after spinal surgery improved quality of recovery, lowered pain scores, reduced perioperative opioid consumption, allowed early ambulation and decreased stress response but not length of hospital stay.https://www.tandfonline.com/doi/10.1080/11101849.2023.2196113Enhancedrecoveryspinalsurgerynon- insulin diabetic |
| spellingShingle | Sarah Mohamed Elgamal Ashraf Arafat Abdelhalim Emad Abdelmoneim Arida Abdulrahman Magdy Elhabashy Rania Abo-Elfetouh Sabra Enhanced recovery after spinal surgery protocol versus conventional care in non- insulin diabetic patients: A prospective randomized trial Egyptian Journal of Anaesthesia Enhanced recovery spinal surgery non- insulin diabetic |
| title | Enhanced recovery after spinal surgery protocol versus conventional care in non- insulin diabetic patients: A prospective randomized trial |
| title_full | Enhanced recovery after spinal surgery protocol versus conventional care in non- insulin diabetic patients: A prospective randomized trial |
| title_fullStr | Enhanced recovery after spinal surgery protocol versus conventional care in non- insulin diabetic patients: A prospective randomized trial |
| title_full_unstemmed | Enhanced recovery after spinal surgery protocol versus conventional care in non- insulin diabetic patients: A prospective randomized trial |
| title_short | Enhanced recovery after spinal surgery protocol versus conventional care in non- insulin diabetic patients: A prospective randomized trial |
| title_sort | enhanced recovery after spinal surgery protocol versus conventional care in non insulin diabetic patients a prospective randomized trial |
| topic | Enhanced recovery spinal surgery non- insulin diabetic |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2023.2196113 |
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