Evaluation of the Effectiveness of Enhanced Recovery after Surgery (ERAS) Protocols in Reducing Postoperative Morbidity in Major Abdominal Surgery

Abstract

Background: Enhanced Recovery after Surgery (ERAS) guidelines represent evidence-based methods of perioperative care aimed at alleviating surgical stress, preserving physiological functions, and speeding up the recovery process. Their use in major abdominal surgery has been linked with better outcomes in postoperative outcomes, but their efficacy in the reduction of morbidity is a subject of continuing review.

Place and Duration of Study: This research was carried out in Department of General Surgery and Anesthesaia, Sindh Institute of Urology and Transplantation (SIUT) from January 2025 to June 2025. Objective: To assess how well the ERAS protocols help to reduce postoperative morbidity in patients undergoing major abdominal surgery.

Methodology: The study was done on 150 patients who were undergoing major abdominal surgery; they were divided into two groups; ERAS (n=75) and conventional care (n=75). WHO sample size calculator was used to determine the sample size. Both male and female patients aged 18-70 years were included. A structured proforma was used to collect data which included demographics, clinical parameters, type of surgery and postoperative outcomes. ERA’s group was given uniform perioperative treatment including preoperative counseling, optimized nutrition, carbohydrate loading, minimum fasting, early mobilization, early drain and catheter removal and oral feeding commenced within 24 hours. The standard group was given standard postoperative care. Postoperative complications (surgical site infections, pulmonary complications, and postoperative ileus) and length of hospital stay were used as primary and secondary outcomes, respectively. Data were processed with the help of SPSS 25.0 and chi-square, and t-tests were used with p 0.05 being significant.

Results: Patients treated according to ERAS guidelines showed a great decrease in morbidity in the postoperative period in comparison to the control group. Surgical site infections, pulmonary complications, as well as postoperative ileus were less common in the ERAS group. Moreover, the ERAS patients were also characterized by a shorter length of stay and quicker recovery.

Conclusion: ERAS guidelines can be used to minimize the postoperative morbidity of major abdominal surgery patients. They can be implemented to achieve better clinical outcomes, fewer complications, and reduced hospital stays, which is why they are a worthy tool in contemporary surgical practice.