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What is the role of enhanced recovery after surgery in children? A scoping review

What is the role of enhanced recovery after surgery in children? A scoping review
What is the role of enhanced recovery after surgery in children? A scoping review
Purpose: Enhanced Recovery after Surgery (ERAS) pathways are standard practice in adult specialties resulting in improved outcomes. It is unclear whether ERAS principles are applicable to Paediatric Surgery. We performed a scoping review to identify the extent to which ERAS has been used in Paediatric Surgery, the nature of interventions and outcomes. Methods: Pubmed, Cochrane library, Google Scholar and Embase were searched using the terms enhanced recovery, post-operative protocol/pathway and paediatric surgery. Studies were excluded if they did not include abdominal/thoracic/urological procedures in children. Results: Nine studies were identified (2003-2014; total 1269 patients): Three case control studies, one retrospective review and five prospective implementations, no RCTs. Interventional elements identified were post-operative feeding, mobilisation protocols, morphine-sparing analgesia, reduced use of nasogastric tubes and urinary catheters. Outcomes reported included post-operative length of stay (LOS), time to oral feeding and stooling, complications and parent satisfaction. Fast-track programmes significantly reduced LOS in 6/7 studies, time to oral feeding in 3/3 studies and time to stooling in 2/3 studies. Conclusion: The use of ERAS pathways in Paediatric surgery appears very limited but such pathways may have benefits in children. Prospective studies should evaluate interventions used in adult ERAS on outcomes in the paediatric setting.
0179-0358
1-9
Hall, Nigel
6919e8af-3890-42c1-98a7-c110791957cf
Pearson, Katherine
392c1782-0259-4aba-a517-0e0fbc082083
Hall, Nigel
6919e8af-3890-42c1-98a7-c110791957cf
Pearson, Katherine
392c1782-0259-4aba-a517-0e0fbc082083

Hall, Nigel and Pearson, Katherine (2016) What is the role of enhanced recovery after surgery in children? A scoping review. Paediatric Surgery International, 1-9. (In Press)

Record type: Article

Abstract

Purpose: Enhanced Recovery after Surgery (ERAS) pathways are standard practice in adult specialties resulting in improved outcomes. It is unclear whether ERAS principles are applicable to Paediatric Surgery. We performed a scoping review to identify the extent to which ERAS has been used in Paediatric Surgery, the nature of interventions and outcomes. Methods: Pubmed, Cochrane library, Google Scholar and Embase were searched using the terms enhanced recovery, post-operative protocol/pathway and paediatric surgery. Studies were excluded if they did not include abdominal/thoracic/urological procedures in children. Results: Nine studies were identified (2003-2014; total 1269 patients): Three case control studies, one retrospective review and five prospective implementations, no RCTs. Interventional elements identified were post-operative feeding, mobilisation protocols, morphine-sparing analgesia, reduced use of nasogastric tubes and urinary catheters. Outcomes reported included post-operative length of stay (LOS), time to oral feeding and stooling, complications and parent satisfaction. Fast-track programmes significantly reduced LOS in 6/7 studies, time to oral feeding in 3/3 studies and time to stooling in 2/3 studies. Conclusion: The use of ERAS pathways in Paediatric surgery appears very limited but such pathways may have benefits in children. Prospective studies should evaluate interventions used in adult ERAS on outcomes in the paediatric setting.

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Accepted/In Press date: 22 September 2016
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 400768
URI: http://eprints.soton.ac.uk/id/eprint/400768
ISSN: 0179-0358
PURE UUID: 79870d0c-dc8b-42d7-b5bf-cbf9c002fb80
ORCID for Nigel Hall: ORCID iD orcid.org/0000-0001-8570-9374

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Date deposited: 26 Sep 2016 13:29
Last modified: 07 Oct 2020 04:20

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