Baseline assessment of enhanced recovery after pediatric surgery in mainland China
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In brief
In brief
Nationwide survey of 66 pediatric surgery centers in China reveals inconsistent ERAS protocol implementation, with mean adoption of 10 out of 17 key elements. Critical gaps identified in preoperative analgesia (9%), PONV prevention (14%), and postoperative pain management (39%), primarily due to institutional barriers and multidisciplinary coordination challenges.
Written by the GCMD Library team from the article.
Abstract
Background
Enhanced recovery after surgery (ERAS) is a clinical pathway that optimizes perioperative management based on evidence-based medicine. ERAS has been gradually introduced to pediatric surgery in recent years. However, there are limited reports on its overall implementation. We aimed to determine the implementation of ERAS in patients who received pediatric surgery in mainland China.
Methods
We designed a questionnaire involving 17 key ERAS elements and sent the questionnaire to 66 chiefs of pediatric surgery distributed throughout 31 provinces in mainland China to obtain a baseline assessment of the assimilation of ERAS protocols in the care of congenital biliary dilatation (CBD).
Results
A total of 66 questionnaires were collected. The range of elements implemented at participating centers was 4–16, with a mean of 10.23. The least commonly practiced elements were administration of non-opioid preoperative analgesia (6 centers, 9.09%), prevention of postoperative nausea and vomiting [PONV] (9 centers, 13.64%), and postoperative pain management (26 centers, 39.39%).
Conclusions
The implementation of elements differed from center to center. Measures relying primarily on anesthesiologists had lower execution. The adherence to ERAS elements was often inhibited by a lack of institutional support, poor knowledge of ERAS protocols, and difficulties in coordinating multidisciplinary care, as well intransigence in changing surgical practices out of fear of liability for poor outcomes.