A Look Forward and a Look Back: The Growing Role of ERAS Protocols in Orthopedic Surgery

Anesthesiol Clin. 2024 Jun;42(2):345-356. doi: 10.1016/j.anclin.2023.11.014.

Abstract

The success of enhanced recovery after surgery (ERAS) protocols in improving patient outcomes and reducing costs in general surgery are widely recognized. ERAS guidelines have now been developed in orthopedics with the following recommendations. Preoperatively, patients should be medically optimized with a focus on smoking cessation, education, and anxiety reduction. Intraoperatively, using multimodal and regional therapies like neuraxial anesthesia and peripheral nerve blocks facilitates same-day discharge. Postoperatively, early nutrition with appropriate thromboprophylaxis and early mobilization are essential. As the evidence of their improvement in patient outcomes and satisfaction continues, these pathways will prove invaluable in optimizing patient care in orthopedics.

Keywords: Ambulatory surgery; Clinical pathways; ERAS; Multimodal analgesia; Orthopedic surgery.

Publication types

  • Review

MeSH terms

  • Enhanced Recovery After Surgery*
  • Humans
  • Orthopedic Procedures* / methods