AUGS-IUGA Joint Clinical Consensus Statement on Enhanced Recovery After Urogynecologic Surgery: Developed by the Joint Writing Group of the International Urogynecological Association and the American Urogynecologic Society. Individual writing group members are noted in the Acknowledgements section.
Journal
Urogynecology (Philadelphia, Pa.)
ISSN: 2771-1897
Titre abrégé: Urogynecology (Phila)
Pays: United States
ID NLM: 9918452588006676
Informations de publication
Date de publication:
01 11 2022
01 11 2022
Historique:
entrez:
26
10
2022
pubmed:
27
10
2022
medline:
29
10
2022
Statut:
ppublish
Résumé
Enhanced recovery after surgery (ERAS) evidence-based protocols for perioperative care can lead to improvements in clinical outcomes and cost savings. This article aims to present consensus recommendations for the optimal perioperative management of patients undergoing urogynecological surgery. A review of meta-analyses, randomized clinical trials, large nonrandomized studies, and review articles was conducted via PubMed and other databases for ERAS and urogynecological surgery. ERAS protocol components were established, and then quality of the evidence was both graded and used to form consensus recommendations for each topic. These recommendations were developed and endorsed by the writing group, which is comprised of the American Urogynecologic Society and the International Urogynecological Association members. All recommendations on ERAS protocol items are based on best available evidence. The level of evidence for each item is presented accordingly. The components of ERAS with a high level of evidence to support their use include fasting for 6 h and taking clear fluids up to 2 h preoperatively, euvolemia, normothermia, surgical site preparation, antibiotic and antithrombotic prophylaxis, strong antiemetics and dexamethasone to reduce postoperative nausea and vomiting, multimodal analgesia and restrictive use of opiates, use of chewing gum to reduce ileus, removal of catheter as soon as feasible after surgery and avoiding systematic use of drains/vaginal packs. The evidence base and recommendations for a urogynecology-relevant ERAS perioperative care pathway are presented in this consensus review. There are several elements of ERAS with strong evidence of benefit in urogynecological surgery.
Identifiants
pubmed: 36288110
doi: 10.1097/SPV.0000000000001252
pii: 02273501-202211000-00002
doi:
Substances chimiques
Chewing Gum
0
Antiemetics
0
Fibrinolytic Agents
0
Opiate Alkaloids
0
Anti-Bacterial Agents
0
Dexamethasone
7S5I7G3JQL
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
716-734Informations de copyright
Copyright © 2022 American Urogynecologic Society and the International Urogynecological Association. All rights reserved.
Déclaration de conflit d'intérêts
The authors have declared they have no conflicts of interest.
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