Pre- and post-enhanced recovery after surgery (ERAS) protocols for laparoscopic hysterectomy

Surgery causes the body to enter a catabolic state, which can lead to complications in the postoperative period. However, protocols have been created to overcome this state, starting preoperatively with surgical and anesthetic approaches. Therefore, we explored the implementation of the Enhanced Recovery After Surgery (ERAS) protocol compared to non-ERAS care at a rural hospital in South Charlotte for patients undergoing laparoscopic or robotic-assisted hysterectomies. Our overarching clinical question was: In 30- to 70-year-old female patients who underwent laparoscopic hysterectomies (with or without robotics), how did the use of an ERAS protocol compare to traditional care impact postoperative pain scores, postoperative nausea and vomiting, or length of stay at a community hospital in South Charlotte? Data were collected via a retrospective chart review of 50 charts per age group (30-50 years old and 51-70 years old), and information was analyzed using descriptive and correlational statistics. The retrospective chart review for this QI project found no significant difference in the medications provided in the preoperative, intraoperative, or postoperative setting, thus leading to no significant difference in postoperative pain, PONV, or length of stay between the ERAS and non-ERAS groups at this specific site. However, this is not a negative outcome. This showed that regardless of the surgeon’s particular order, most patients received multimodal anesthesia; therefore, if all patients received multimodal anesthesia, there should be an overall decrease in PONV, PACU pain, and LOS.