Department of Pediatric Orthopedics, The Second Affiliated Hospital of Jiaxing University (The Second Hospital of Jiaxing), Zhejiang, Jiaxing, 314000, People's Republic of China.
Department of Anesthesiology, The Second Affiliated Hospital of Jiaxing University (The Second Hospital of Jiaxing), Zhejiang, Jiaxing, 314000, People's Republic of China.
BMC Musculoskelet Disord. 2022 Jul 25;23(1):705. doi: 10.1186/s12891-022-05675-1.
This study assessed whether an enhanced recovery after surgery (ERAS) protocol could be beneficial for children with distal humerus fractures.
Children with distal humerus fractures (n = 85) were randomly assigned to the ERAS and control groups and subjected to different perioperative managements. This was followed by the evaluation of their intraoperative characteristics (operation time and bleeding), postoperative characteristics (food intake conditions, pain scores, and discharge time), and postoperative functions.
The operation time, intraoperative bleeding, and postoperative hematological indices did not differ significantly between the two groups. Preoperative thirst and hunger were considerably less and the initial food intake duration following surgery was markedly shorter in the ERAS group than in the control group, whereas no difference between the groups was observed in the incidences of postoperative nausea and vomiting. A markedly reduced highest postoperative pain score and reduced mean pain score and demand for additional analgesic interventions were observed in the ERAS group compared with those in the control group, although the differences were not statistically significant. No noticeable between-group differences were observed in the incidences of postoperative incision problems, aspirational pneumonia, and gastroesophageal reflux. The total length of hospital stay was not significantly different between the two groups. However, the length of postoperative hospital stay was remarkably shorter and the elbow joint function at 2 months after surgery was significantly improved in the ERAS group compared with those in the control group.
The ERAS protocol can ameliorate preoperative discomfort and postoperative pain, shorten the postoperative hospital stay, and accelerate postoperative functional recovery without increasing the risks of postoperative nausea, vomiting, and poor incision healing and is, therefore, worthy of clinical application.
本研究旨在评估外科手术后加速康复（ERAS）方案是否有益于儿童肱骨远端骨折。
将 85 例肱骨远端骨折患儿随机分为 ERAS 组和对照组，并采用不同的围手术期管理。然后评估他们的术中特点（手术时间和出血量）、术后特点（进食情况、疼痛评分和出院时间）和术后功能。
两组患儿的手术时间、术中出血量和术后血液学指标无显著差异。ERAS 组术前口渴和饥饿感明显减轻，术后首次进食时间明显缩短，而术后恶心和呕吐的发生率两组间无差异。与对照组相比，ERAS 组术后最高疼痛评分明显降低，平均疼痛评分和需要额外镇痛干预的次数减少，但差异无统计学意义。两组术后切口问题、吸入性肺炎和胃食管反流的发生率无明显差异。两组患儿的总住院时间无显著差异。然而，ERAS 组术后住院时间明显缩短，术后 2 个月时肘关节功能明显改善。
ERAS 方案可以减轻术前不适和术后疼痛，缩短术后住院时间，加速术后功能恢复，且不会增加术后恶心、呕吐和切口愈合不良的风险，值得临床应用。
