Huang Xuezhu, Deng Sisi, Lei Xiaofeng, Lu Shentao, Dai Ling, She Chunyan
Department of Anaesthesiology, Women and Children's Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children), Chongqing, China.
Department of Gynaecology and Obstetrics, Women and Children's Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children), Chongqing, China.
BMC Med. 2025 Jan 27;23(1):43. doi: 10.1186/s12916-025-03880-y.
Prospective trial evidence is lacking regarding the application of enhanced recovery after surgery (ERAS) in transvaginal pelvic floor reconstruction surgery among older patients. Our study aimed to investigate whether implementing the ERAS protocol could enhance post-operative recovery in this patient population.
Older patients undergoing elective transvaginal pelvic floor reconstruction surgery were randomly assigned to either the ERAS group or the conventional group. The primary outcome was post-operative length of stay (LOS). The secondary outcomes encompassed other post-operative recovery metrics, post-operative pain within 30 days, the occurrence of complications, the peri-operative blood test and cognitive function.
A cohort of 100 patients was enrolled. Implementation of the ERAS protocol significantly reduced the duration of post-operative LOS (74.00 (69.00, 96.00) vs. 65.00 (59.00, 78.25) h, P < 0.01). Additionally, the ERAS protocol significantly reduced the duration of the first oral intake post-operatively (5.00 (2.50, 7.00) vs. 3.00 (2.00, 4.00) h, P = 0.01), and reduced rest and movement-related pain within 48 h post-operatively, effects that persisted through the 7-day follow-up period. It also shortened the duration of post-operative laryngeal mask airway support and promoted opioid-sparing. Moreover, the incidence and severity of post-operative nausea and vomiting (PONV) were significantly lower in the ERAS group compared to the conventional group at 12 h post-operatively.
Implementation of the ERAS protocol can expedite post-operative recovery in older patients undergoing transvaginal pelvic floor reconstruction surgery, achieve opioid-sparing, alleviate pain post-operatively, and decrease the incidence of complications.
This study was retrospectively registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2400084608). The date of first registration was 21/05/2024.
关于老年患者经阴道盆底重建手术中应用加速康复外科（ERAS）的前瞻性试验证据不足。我们的研究旨在调查实施ERAS方案是否能促进该患者群体的术后恢复。
将接受择期经阴道盆底重建手术的老年患者随机分为ERAS组和传统组。主要结局指标是术后住院时间（LOS）。次要结局指标包括其他术后恢复指标、术后30天内的疼痛、并发症的发生情况、围手术期血液检查和认知功能。
共纳入100例患者。实施ERAS方案显著缩短了术后住院时间（74.00（69.00，96.00）小时 vs. 65.00（59.00，78.25）小时，P < 0.01）。此外，ERAS方案显著缩短了术后首次经口进食的时间（5.00（2.50，7.00）小时 vs. 3.00（2.00，4.00）小时，P = 0.01），并减轻了术后48小时内与休息和活动相关的疼痛，这些效果在7天随访期内持续存在。它还缩短了术后喉罩气道支持的时间，并促进了阿片类药物的节省。此外，与传统组相比，ERAS组术后12小时的术后恶心呕吐（PONV）发生率和严重程度显著更低。
实施ERAS方案可加快接受经阴道盆底重建手术的老年患者的术后恢复，实现阿片类药物的节省，减轻术后疼痛，并降低并发症的发生率。
本研究在 Chinese Clinical Trial Registry 进行了回顾性注册（注册号：ChiCTR2400084608）。首次注册日期为2024年5月21日。
