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Title of Journal: Arch Orthop Trauma Surg

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Abbravation: Archives of Orthopaedic and Trauma Surgery

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Springer-Verlag

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DOI

10.1002/ppap.201400210

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1434-3916

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The use of enhanced recovery after surgery ERAS

Authors: Nicholas B Scott David McDonald Jane Campbell Richard D Smith A Kate Carey Ian G Johnston Kate R James Steffen J Breusch
Publish Date: 2012/10/16
Volume: 133, Issue: 1, Pages: 117-124
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Abstract

In 2010 National Services Scotland’s Musculoskeletal Audit was asked to perform a ‘snapshot’ audit of the current perioperative management of patients undergoing total hip and knee arthroplasty in all 22 Scottish orthopaedic units with an identical followup audit in 2011 after input and support from the national steering groupThe number of Scottish units that developed an ERAS programme increased from 8 36  to 15 68  Units that included more ERAS patients had earlier mobilisation rates 146/474 36  ERAS patients mobilised same day vs 34/873 4  nonERAS n = 22 units r = 055 p = 0008 and shorter postoperative length of stay median 4 days vs ERAS 5 days nonERAS n = 22 units r = −064 p = 0001 ERAS knee arthroplasty patients had lower blood transfusion rates 5/205 2  vs 51/399 13  n = 22 units r = −062 p = 0002 Units that restricted the use of IV fluids postoperatively had higher early mobilisation rates n = 22 units r = 048 p = 003 and shorter postoperative length of stay n = 22 units r = −056 p = 0007 Reduced use of patientcontrolled analgesia was also associated with earlier mobilisation n = 22 units r = 049 p = 002 and shorter length of stay n = 22 units r = −039 p = 007 Urinary catheterisation rates also dropped from 468/1345 35  in 2010 to 337/1278 26  in 2011 n = 22 units z = 219 p = 003A clinically guided and nationally supported process has proven highly successful in achieving a further uptake of enhanced recovery principles after lower limb arthroplasty in Scotland which has resulted in clinical benefits to patients and reduced length of hospital stayNone of the authors is aware of any competing interests We wish to declare no support from any organisation for the submitted work no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years and no other relationships or activities that could appear to have influenced the submitted work

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  3. Evaluation of clinical problems associated with bone metastases from carcinoma from unknown primary sites
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  11. Conservative treatment after failure of internal fixation for periprosthetic femoral fractures: a report of two cases
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