Hua Lei,Yu Jie,Ren Yi,et al.Efficacy of enhanced recovery after surgery on postoperative recovery in funnel chest children undergoing Nuss surgery[J].Journal of Clinical Pediatric Surgery,,():1082-1087.[doi:10.3760/cma.j.cn101785-202401041-015]
Efficacy of enhanced recovery after surgery on postoperative recovery in funnel chest children undergoing Nuss surgery
- Keywords:
- Funnel Chest; Thoracic Surgical Procedures; Enhanced Recovery after Surgery; Treatment Outcome; Child
- Abstract:
- Objective To explore the effectiveness and safety of enhanced recovery after surgery (ERAS) strategies on postoperative recovery for funnel chest children undergoing Nuss procedure. Methods A total of 99 children undergoing elective Nuss procedure were randomized into two groups of ERAS (n=50) and control (n=49).The strategies of ERAS group included preoperative education,breathing exercises,shortening preoperative water fasting time,multimodal analgesia,depth of anesthesia monitoring,lung-protective ventilation and prevention of postoperative nausea & vomiting.Control group fasted for 6 h,only took intravenous opioids for analgesia,no lung protective ventilation and there was no dosing of preventive antiemetic.Postoperative pain score,opioid-related adverse events (constipation,nausea & vomiting),incidence of pulmonary complications,length of hospitalization,laboratory tests (C-reactive protein,white blood cell count & neutrophil proportion) and other outcome parameters were compared between two groups. Results At postoperative 1/6 h,numerical rating scale (NRS) scores were 3.0(1.8,5.0) and 3.5(3.0,5.0) in ERAS group.Both were significantly lower than that in control group (4.0and 4.0) (P<0.05).Cumulative usage of PCA was 41.5(30.8,52.3) ml and it was significantly lower than 57.9(43.0,74.0) ml in control group (P<0.05).Twelve cases (12/50,24%) developed adverse events related to postoperative analgesia.It was significantly lower than 18 cases (18/49,36.7%) in control group (P<0.05).No significant inter-group difference existed in NRS scores at postoperative 12/24/48 h,the incidence of postoperative pulmonary complications,length of hospitalization,total expense or postoperative blood tests (all P>0.05). Conclusions Both safe and effective for children undergoing NUSS procedure,ERAS strategies may reduce postoperative pain score and usage of opioid within postoperative 6 h and lower the incidence of analgesic-related adverse events.However,there is insufficient evidence of ERAS on shortening length of hospitalization and lowering the incidence of postoperative pulmonary complications.
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Memo
收稿日期:2024-1-18。
基金项目:吴阶平医学基金会临床科研专项基金自助项目(320.6750.19089-102)
通讯作者:张建敏,Email:zjm428@sina.com