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Abstract

Background: Enhanced Recovery After Surgery (ERAS) protocols are multimodal, evidence-based pathways designed to optimize perioperative care and accelerate recovery in surgical patients. Conventional postoperative care, characterized by prolonged fasting and delayed mobilization, may contribute to longer hospital stays and higher complication rates. This study compares ERAS protocols with conventional care in major abdominal surgery, focusing on hospital length of stay (LOS) and postoperative complications.
Methods: A prospective comparative study was conducted at a tertiary care hospital involving 100 patients undergoing elective major abdominal surgeries (e.g., colectomies, gastrectomies). Patients were allocated into ERAS (n=50) or conventional care (n=50) groups. The ERAS protocol included preoperative carbohydrate loading, early oral intake, multimodal analgesia, and enforced mobilization. Conventional care involved traditional practices like prolonged fasting and opioid-based pain control. Primary outcomes were LOS and complication rates, analyzed using statistical methods including multivariate regression.
Results: The ERAS group had a significantly shorter median LOS (5 vs. 8 days, p<0.001) and lower overall complication rates (16% vs. 36%, p=0.02), with ileus being notably reduced (4% vs. 12%, p=0.04). Time to first oral intake (12.4 vs. 48.6 hours, p<0.001) and ambulation (10.5 vs. 36.2 hours, p<0.001) was shorter in the ERAS group. Readmission rates were comparable (6% vs. 10%, p=0.47). High ERAS compliance (>85%) correlated with better outcomes. Multivariate analysis confirmed ERAS as an independent predictor of reduced LOS (OR: 0.32, p<0.001).
Conclusion: ERAS protocols significantly reduce hospital stay and postoperative complications in major abdominal surgery without increasing readmission rates. These findings support the adoption of ERAS as a standard of care, emphasizing early mobilization, nutritional support, and multimodal analgesia. Future research should focus on broader implementation and cost-benefit analysis.