Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Department of Orthopaedics and Trauma Surgery, National Trauma Center, National Academy of Medical Sciences, Mahankal, Kathmandu, Nepal.
BMC Musculoskelet Disord. 2020 Apr 13;21(1):234. doi: 10.1186/s12891-020-03243-z.
Enhanced recovery after surgery (ERAS) has been shown to shorten the length of hospital stay and reduce the incidence of perioperative complications in many surgical fields. However, there has been a paucity of research examining the application of ERAS in major pediatric orthopaedic surgeries. This study aims to compare the perioperative complications and length of hospital stay after osteotomies in children with developmental dysplasia of the hip (DDH) between ERAS and traditional non-ERAS group.
The ERAS group consisted of 86 patients included in the ERAS program from January 2016 to December 2017. The Control group consisted of 82 DDH patients who received osteotomies from January 2014 to December 2015. Length of hospital stay, physiological function, postoperative visual analogue scale (VAS) score, and postoperative complications were compared between the two groups.
The mean duration of hospital stay was significantly reduced from 10.0 ± 3.1 in the traditional care group to 6.0 ± 0.8 days in the ERAS(P < 0.001). The average VAS score in the first 3 days was significantly lower in the ERAS group (2.9 ± 0.8) than the traditional non-ERAS group (4.0 ± 0.8) (P < 0.001). However, there was no significant difference in the frequency of break-out pain (VAS > 4) between two groups (29.5 ± 6.3 times vs.30.6 ± 6.5 times, P = 0.276). The frequency of postoperative fever was lower in the ERAS group. The frequency of urinary tract infection in both groups were not noticeable because the catheter was removed promptly after the surgery.
The ERAS protocol is both safe and feasible for pediatric DDH patients undergoing osteotomies, and it can shorten the length of hospital stay without increasing the risk of perioperative complications.
加速康复外科（ERAS）已被证明可缩短许多外科领域的住院时间并降低围手术期并发症的发生率。然而，关于 ERAS 在小儿矫形外科手术中的应用的研究很少。本研究旨在比较发育性髋关节发育不良（DDH）患儿行截骨术后 ERAS 组和传统非 ERAS 组的围手术期并发症和住院时间。
ERAS 组纳入 2016 年 1 月至 2017 年 12 月期间接受 ERAS 方案的 86 例患者。对照组纳入 2014 年 1 月至 2015 年 12 月期间接受截骨术的 82 例 DDH 患者。比较两组的住院时间、生理功能、术后视觉模拟评分（VAS）和术后并发症。
与传统护理组的 10.0±3.1 天相比，ERAS 组的住院时间明显缩短至 6.0±0.8 天（P<0.001）。ERAS 组前 3 天的平均 VAS 评分（2.9±0.8）明显低于传统非 ERAS 组（4.0±0.8）（P<0.001）。然而，两组之间爆发性疼痛（VAS>4）的频率没有显著差异（29.5±6.3 次与 30.6±6.5 次，P=0.276）。ERAS 组术后发热的频率较低。两组的尿路感染发生率均不明显，因为手术后导管很快被移除。
ERAS 方案对接受截骨术的小儿 DDH 患者既安全又可行，可缩短住院时间，而不增加围手术期并发症的风险。
