Enhanced Recovery After Surgery Pathways in Pediatric Spinal Surgery: A Systematic Review and Meta-Analysis.
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
30 Jul 2024
30 Jul 2024
Historique:
received:
22
05
2024
revised:
22
07
2024
accepted:
23
07
2024
medline:
2
8
2024
pubmed:
2
8
2024
entrez:
1
8
2024
Statut:
aheadofprint
Résumé
Pediatric spinal fusion surgery is a complex procedure that poses challenges in perioperative management. The enhanced recovery after surgery (ERAS) approach is an evidence-based, multidisciplinary strategy to optimize patient care in an individualized, multidisciplinary way. Despite the benefits of ERAS protocol implementation, the role of ERAS in pediatric spine surgery remains understudied. This systematic review and meta-analysis aims to evaluate the current literature regarding pediatric spinal surgery ERAS protocols and their ability to decrease the LOS, pain, time-to-stand, and complications. A systematic review was conducted using PRISMA guidelines. Statistical analyses were performed using Cochrane's RevMan (version 5.4). 17 studies totaling 2,733 patients were included in this analysis. Patients treated in an ERAS protocol had significant reductions in LOS (p < 0.001), time-to-stand (p < 0.001), total complications (p = 0.02), and estimated blood loss (p = 0.001). ERAS protocol implementation can significantly enhance outcomes for pediatric patients receiving spinal surgery. Consequently, ERAS protocols have the potential to lower healthcare expenses, increase access, and set a new standard of care. Future research should be conducted to expand pediatric ERAS protocols to a diverse range of spinal pathologies and assess the long-term advantages of this practice.
Sections du résumé
BACKGROUND
BACKGROUND
Pediatric spinal fusion surgery is a complex procedure that poses challenges in perioperative management. The enhanced recovery after surgery (ERAS) approach is an evidence-based, multidisciplinary strategy to optimize patient care in an individualized, multidisciplinary way. Despite the benefits of ERAS protocol implementation, the role of ERAS in pediatric spine surgery remains understudied.
AIM
OBJECTIVE
This systematic review and meta-analysis aims to evaluate the current literature regarding pediatric spinal surgery ERAS protocols and their ability to decrease the LOS, pain, time-to-stand, and complications.
METHODS
METHODS
A systematic review was conducted using PRISMA guidelines. Statistical analyses were performed using Cochrane's RevMan (version 5.4).
RESULTS
RESULTS
17 studies totaling 2,733 patients were included in this analysis. Patients treated in an ERAS protocol had significant reductions in LOS (p < 0.001), time-to-stand (p < 0.001), total complications (p = 0.02), and estimated blood loss (p = 0.001).
CONCLUSIONS
CONCLUSIONS
ERAS protocol implementation can significantly enhance outcomes for pediatric patients receiving spinal surgery. Consequently, ERAS protocols have the potential to lower healthcare expenses, increase access, and set a new standard of care. Future research should be conducted to expand pediatric ERAS protocols to a diverse range of spinal pathologies and assess the long-term advantages of this practice.
Identifiants
pubmed: 39089650
pii: S1878-8750(24)01310-X
doi: 10.1016/j.wneu.2024.07.170
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Elsevier Inc. All rights reserved.