Laparoscopic Colorectal Surgery Clinical Trial
Official title:
Impact of Enhanced Recovery (ERAS) Protocol After Laparoscopic Colorectal Surgery Implementation on Clinical Outcomes
The study will assess the impact on quality of care after implementation of the ERAS (Enhanced Recovery After Surgery) protocol for laparoscopic colorectal surgery in Vilnius University Hospital Santaros klinikos. The primary goal of this study is to compare efficacy of two different types of anaesthesia - general and combined (spinal and general), efficacy of multimodal analgesia in both groups, need for rescue analgetics, time to bowel movement, time to ambulation. We also aim to study overall patient satisfaction and measure health-related quality of life, from date of randomisation until the date of hospital discharge, 30 days, 3 months and 6 months post-discharge.
Recovery After Surgery (ERAS) protocol is a multimodal perioperative care pathway designed to
achieve early recovery after surgical procedures by maintaining preoperative organ function
and reducing the profound stress response following surgery, now widely accepted in
laparoscopic colorectal surgery.
In laparoscopic colorectal surgery, the ERAS protocol involves an accurate interview with the
patient in the preoperative phase aimed at smoking and alcohol cessation, the reduction of
preoperative fasting with administration of oral carbohydrates before surgery, use of
intestinal preparation for selected cases only, the prophylaxis of thromboembolism, a correct
antibiotic prophylaxis, the prevention of intraoperative hypothermia and hypotension,
prevention of volume overload, preference for minimally invasive surgery, multimodal
analgesia with reduced opioid requirements, local anaesthetics for wound infiltration,
prevention of postoperative nausea and vomiting, very limited use of the nasogastric tube,
early removal of the urinary catheter, multimodal analgesia to minimize opiate consumption,
early postoperative mobilization and early postoperative feeding, to promote rapid recovery
of gastrointestinal functions.
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