Challenges in Enhanced Recovery After Surgery (ERAS) research

Lobo, Dileep N.; Joshi, Girish P.; Kehlet, Henrik

Abstract

Despite the general agreement that implementation of Enhanced Recovery After Surgery (ERAS) pathways decrease hospital length of stay, a continuous challenge that has often been neglected is a procedure- and patient-specific approach. For example, asking ‘Why is the patient still in hospital?’ is the original premise for ERAS. Outcomes improve with increased compliance with recommended elements, but overcomplication of pathways can lead to cherry picking of elements that are convenient, resulting in ‘partial ERAS’. As there are few high-quality randomised clinical trials (RCTs) that evaluate the specific role of individual preoperative, intraoperative, and postoperative elements, challenges lie ahead to identify essential ERAS elements to facilitate more widespread implementation. To achieve this goal, the balance between large RCTs and smaller detailed hypothesis-generating observational studies needs to be addressed in order to enhance knowledge and limit waste of research resources.

Citation

Lobo, D. N., Joshi, G. P., & Kehlet, H. (2024). Challenges in Enhanced Recovery After Surgery (ERAS) research. British Journal of Anaesthesia, 133(4), 717-721. https://doi.org/10.1016/j.bja.2024.06.031

• Journal Article Type: Editorial
• Acceptance Date: Jun 13, 2024
• Online Publication Date: Jul 26, 2024
• Publication Date: 2024-10
• Deposit Date: Jun 14, 2024
• Publicly Available Date: Jul 27, 2025
• Journal: British Journal of Anaesthesia
• Print ISSN: 0007-0912
• Electronic ISSN: 1471-6771
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 133
• Issue: 4
• Pages: 717-721
• DOI: https://doi.org/10.1016/j.bja.2024.06.031
• Keywords: enhanced recovery after surgery; evidence; fast-track surgery; methodology; problems; research
• Public URL: https://nottingham-repository.worktribe.com/output/36014858
• Publisher URL: https://www.bjanaesthesia.org/article/S0007-0912(24)00406-9/abstract