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Pediatric Surgery International

Erschienen in:

21.07.2020 | Original Article

The impact of an enhanced recovery perioperative pathway for pediatric pectus deformity repair

verfasst von: Sabrina Mangat, Lyla Hance, Karene J. Ricketts, Michael R. Phillips, Sean E. Mclean

Erschienen in: Pediatric Surgery International | Ausgabe 9/2020

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Abstract

Purpose

Pediatric repair of chest wall deformities is associated with significant pain, morbidity, and resource utilization. We sought to determine outcomes of a perioperative enhanced recovery after surgery (ERAS) pathway for patients undergoing minimally invasive (Nuss) and traditional (Ravitch) corrective procedures.

Methods

Our ERAS protocol was implemented in 2015. We performed a retrospective review of patients for Nuss or Ravitch procedures before and after ERAS implementation. Combined and procedure segregated bivariate analyses were conducted on postoperative outcomes and resource utilization.

Results

There are 17 patients in the pre-intervention group (Nuss = 13 and Ravitch = 4) compared to 38 patients in the post-intervention group (Nuss = 28 and Ravitch = 10). Protocol implementation increased utilization of pre-operative non-narcotic medication. The combined and Nuss post-intervention groups had a significant decrease in epidural duration and time to enteral medications, but had increased total postoperative opioid usage. The Ravitch post-intervention group had a significant decrease in intra-operative narcotics and discharge pain scores. There were no differences in length of stay or complications.

Conclusion

Implementation of our ERAS protocol standardized pectus perioperative care, but did not improve postoperative opioid usage, complications, or resource utilization. Alterations in the protocol may lead to achieving desired goals of better pain management and decreased resource utilization.

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Titel: The impact of an enhanced recovery perioperative pathway for pediatric pectus deformity repair
verfasst von: Sabrina Mangat
Lyla Hance
Karene J. Ricketts
Michael R. Phillips
Sean E. Mclean
Publikationsdatum: 21.07.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 9/2020
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-020-04695-z

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