The clinical application of enhanced recovery after surgery on pharyngeal surgery in children

Objective To evaluate the effect of enhanced recovery after surgery(ERAS) on pharyngeal surgery in children. Methods Sixty childrens aged 6-12 y, scheduled for pharyngeal surgery, were randomly divided into two groups(n=30): group ERAS and conservative treatment surgery group(group CTS). Optimization measures by evidence based medicine for preoperative education, anesthetic management and postoperative analgesia were administered in group ERAS. Meanwhile, group CTS received conventional perioperative care. The hemodynamic index, sedation-agitation scale, and VAS scale were monitored during awaken from anesthesia and 2, 8, 24 h postoperatively. Rescue analgesia and postoperative complications were recorded 24 h after surgery. Hospital stays were also observed. Results There were no significant differences in hemodynamic index and operative time between the those two groups. Group ERAS was associated with a significantly lower sedation-agitation scale[(2.41±0.50), (2.48±0.67), (2.39±0.81), (2.33±0.51)], VAS scale [(3.3±0.5),(3.2±0.5),(3.0±0.6),(2.6±0.9)] and shorter hospital stay [(5.5±0.8) d] compared with group CTS[(3.54±1.01),(3.63±0.92), (3.42±0.32),(3.38±0.20)],[(5.3±0.4), (4.9±0.3), (4.8±0.4), (3.9±0.5)],[(7.1±0.5) d]. Group ERAS(30%) also received less rescue analgesia than group CTS(50%). Incidence rate of postoperative nausea and vomiting was lower in group ERAS(33.3%) than group CTS(66.7%). Conclusions ERAS is feasible and effective for pharyngeal surgery in children, with improvements of postoperative rehabilitation, postoperative pain, hospital stay and patients' satisfaction. Key words: Pediatric anesthesia; Pharyngeal surgery; Enhanced recovery after surgery