PT - JOURNAL ARTICLE AU - Vijayan Purushothaman AU - Pratyusha Priyadarshini AU - Dinesh Bagaria AU - Mohit Joshi AU - Narendra Choudhary AU - Abhinav Kumar AU - Subodh Kumar AU - Amit Gupta AU - Biplab Mishra AU - Purva Mathur AU - Sushma Sagar TI - Enhanced recovery after surgery (ERAS) in patients undergoing emergency laparotomy after trauma: a prospective, randomized controlled trial AID - 10.1136/tsaco-2021-000698 DP - 2021 Aug 01 TA - Trauma Surgery & Acute Care Open PG - e000698 VI - 6 IP - 1 4099 - http://tsaco.bmj.com/content/6/1/e000698.short 4100 - http://tsaco.bmj.com/content/6/1/e000698.full SO - Trauma Surg Acute Care Open2021 Aug 01; 6 AB - Background The role of enhanced recovery after surgery (ERAS) has been established in elective operations. However, its role in emergency operations especially in trauma is under-recognized. The aim of this study was to explore the safety and efficacy of ERAS program in patients undergoing emergency laparotomy for trauma.Methods In this single-center study, patients who underwent emergency laparotomy after trauma were randomized to the ERAS protocol or conventional care. The ERAS protocol included early removal of catheters, early initiation of diet, use of postoperative prophylaxis and optimal usage of analgesia. The primary endpoint was duration of hospital stay. The secondary endpoints were recovery of bowel function, pain scores, complications and readmission rate.Results Thirty patients were enrolled in each arm. The ERAS group had significant reduction in duration of hospital stay (3.3±1.3 vs. 5.0±1.7; p<0.01). Time to remove nasogastric tube (1.1±0.1 vs. 2.2±0.9; p<0.01), urinary catheter (1.1±0.1 vs. 3.5±1.6; p<0.01), and drain (1.0±0.2 vs. 3.7±1.6; p<0.01) was shorter in the ERAS group. In ERAS group, there was earlier initiation of liquid diet (1.1±0.1 vs. 2.3±1.0; p<0.01) and solid diet (2.1±0.1 vs. 3.6±1.3; p<0.01). The usage of epidural analgesia (63% vs. 30%; p=0.01), non-steroidal anti-inflammatory drugs (93% vs. 67%; p-0.02) and deep vein thrombosis prophylaxis (100% vs. 70%; p<0.01) was higher in the ERAS group. There was no difference in the recovery of bowel function (2.4±1.0 vs. 2.1±0.9; p=0.15), pain scores (3.2±1.0 vs. 3.1±1.1; p=0.87), complications (27% vs. 23%; p=0.99) and readmission rates (07% vs. 10%; p=0.99) between the two groups.Conclusion ERAS protocol, when implemented in patients undergoing laparotomy for trauma, has decreased duration of hospital stay with no additional complications.Level of evidence Level 1, randomized controlled trial, care management.Trial registration number Clinical Trials Registry of India (CTRI/2019/06/019533).Data are available upon request.