The use of the ERAS protocol for planned gynecological surgery: a prospective, non-randomized controlled trial

Background. Protocols for accelerated rehabilitation after surgery are used throughout the world, but are not widespread in Russia. We conducted a study to determine the effectiveness and safety of the Fast Track approach in our country. Objective. Comparison of various parameters of course of the postoperative period and rehabilitation between female patients included in the ERAS protocol and traditional postoperative management. Methods. The prospective, non-randomized study included 2 groups of female patients (I - n=29, II - n=27) awaiting planned gynecological surgery. Patients of group I were managed according to the Fast Track protocol, and traditional approaches were used for perioperative management of group II. The primary end point was the number of hours spent in the hospital. Secondary end points included the incidence of complications in the postoperative period (fever, nausea, vomiting, the number of repeated admissions and operations), the pain level. Results. In group I, the mean hospital stay was 5.9±0.9 hours, while in group II - 163.6±12.3 hours (p<0.001). The pain level according to MS was lower in group I during the first 2 days. 48 hours after surgery, the pain was equally in both groups. Postoperative vomiting occurred in 3.6% of patients in group I and in 18% of patients in group II (p<0.001). There were no significant differences in the frequency of other complications. Conclusion. The Fast Track protocol can be safely embedded in Russian healthcare service. This study has shown that it allows to accelerate the rehabilitation of patients without increasing the complication frequency.

Fast Track protocol, rehabilitation