Enhanced Recovery after Surgery Program in the Perioperation of Adolescent Idiopathic Scoliosis and Its Effect Evaluation

  Objective  The aim of this study was to summarize the integrated program of enhanced recovery after surgery (ERAS) in the perioperation of adolescent idiopathic scoliosis (AIS) and to evaluate its impact on the recovery.

  Methods  Among the continuous cohort of AIS patients who underwent the orthopedic surgery in Peking Union Medical College Hospital from January 2007 to January 2017, the initial 100(Cases 1-100, traditional group) and the last 100 cases (Cases 1193-1292, ERAS group) were enrolled in this study. The preoperative, intraoperative, and postoperative enhanced recovery managements were performed in the ERAS group. The related recovery indicators were compared between the two groups, including the length of stay, the postoperative length of stay, allogeneic blood transfusion, pain scores at the discharge, the incidence of complications within 30 days, and the incidence of unplanned reoperation within 1 year.

  Results  There was no statistical difference in gender, age, body mass index, surgical segment, and the incidence of unplanned reoperation within 1 year between the two groups. The length of stay and the postoperative length of stay in the traditional group were significantly longer than those in the ERAS groupLength of stay:traditional group (17.18±2.67)days, ERAS group (11.35±1.49)days, P < 0.05; Postoperative length of stay:traditional group (9.34±0.52)days, ERAS group (7.19±0.71)days, P < 0.05. The percentage and volume of allogeneic blood transfusion in the traditional group were both higher than those in the ERAS groupPercentage:traditional group 41%(41/100), ERAS group 20%(20/100), P < 0.05; Volume:traditional group (1.43±0.39)U, ERAS group (0.59±0.12)U, P < 0.05. The pain scores at the discharge of the traditional group(3.40±0.63) points was slightly higher than that of the ERAS group(3.00±0.47) points without the statistical significance.

  Conclusion  Proposal formulation of ERAS program for the surgical treatment of AIS might reduce hospital stay and blood transfusion, and accelerate recovery without increasing complications and reoperation.