Designing Enhanced Recovery After Surgery Protocols in Neurosurgery: A Contemporary Narrative Review

Sagar Jolly; Shashank Paliwal; Aditya Gadepalli; Sheena Chaudhary; Hemant Bhagat; Rafi Avitsian

doi:10.1097/ANA.0000000000000946

Designing Enhanced Recovery After Surgery Protocols in Neurosurgery: A Contemporary Narrative Review

J Neurosurg Anesthesiol. 2023 Nov 22. doi: 10.1097/ANA.0000000000000946. Online ahead of print.

Authors

Sagar Jolly¹, Shashank Paliwal², Aditya Gadepalli³, Sheena Chaudhary⁴, Hemant Bhagat⁵, Rafi Avitsian¹

Affiliations

¹ Department of General Anesthesiology, Cleveland Clinic, OH.
² Department of Anesthesiology, AIIMS, Bathinda, PB, India.
³ Department of Anaesthetics and Intensive Care, Royal Free London NHS Foundation Trust, London, UK.
⁴ Department of Neuroanesthesia and Critical Care, Fortis Memorial Research Institute, Gurugram, HR, India.
⁵ Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

PMID: 38011868
DOI: 10.1097/ANA.0000000000000946

Abstract

Enhanced Recovery After Surgery (ERAS) protocols have revolutionized the approach to perioperative care in various surgical specialties. They reduce complications, improve patient outcomes, and shorten hospital lengths of stay. Implementation of ERAS protocols for neurosurgical procedures has been relatively underexplored and underutilized due to the unique challenges and complexities of neurosurgery. This narrative review explores the barriers to, and pioneering strategies of, standardized procedure-specific ERAS protocols, and the importance of multidisciplinary collaboration in neurosurgery and neuroanesthsia, patient-centered approaches, and continuous quality improvement initiatives, to achieve better patient outcomes. It also discusses initiatives to guide future clinical practice, research, and guideline creation, to foster the development of tailored ERAS protocols in neurosurgery.