Enhanced recovery after abdominal surgery in pediatric patients
Keywords:
enhanced recovery after surgery, perioperative management, abdominal surgery, pediatric patientAbstract
Enhanced Recovery After Surgery (ERAS) guidelines for pediatric patients have been developed over the past decade to reduce the stress responses associated with surgical procedures, preserve organ function, and promote early recovery. Key components of ERAS in pediatric surgery emphasize a multidisciplinary approach, requiring collaboration among pediatric surgeons, pediatricians, anesthesiologists, and nursing staff during the perioperative period. Preoperative management focuses on educating patients and guardians about the surgical procedure and the ERAS protocol, ensuring optimal medical conditions, and establishing appropriate fasting requirements. Intraoperative strategies prioritize minimally invasive techniques over exploratory laparotomy, while avoiding the use of abdominal drains and nasogastric tubes. Other essential practices include proper antibiotic prophylaxis, judicious fluid management, patient normothermia, prophylaxis for nausea and vomiting, and multimodal pain control. Postoperatively, protocols advocate for early ambulation, prompt initiation of enteral feeding, early removal of nasogastric tubes and Foley catheters, and avoidance of intravenous opioids, favoring multimodal pain management instead. The implementation of ERAS protocols in pediatric surgery offers significant benefits for patients, families, and healthcare providers by promoting early mobilization and encouraging parental involvement. ERAS enhances recovery, reduces the incidence of complications, and shortens the length of hospital stay. Additionally, ERAS in pediatrics has shown potential to lower healthcare costs, optimize resource utilization, and improve long-term outcomes for children undergoing surgery. This article presents data on the ERAS protocol for pediatric patients undergoing abdominal surgery, highlighting its advantages, management strategies, and significance in improving preoperative, perioperative, and postoperative care to promote early recovery in pediatric abdominal surgery.
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