Implementation of an Enhanced Recovery After Spine Surgery program at a large cancer center: a preliminary analysis

J Neurosurg Spine. 2018 Nov 1;29(5):588-598. doi: 10.3171/2018.4.SPINE171317. Epub 2018 Aug 17.

Abstract

This study describes the implementation of a multimodal, multidisciplinary, evidence-based ERAS program in oncologic spine surgery, identifies and measures several relevant postoperative recovery outcomes, and demonstrates the feasibility and potential benefit of the program in improving analgesia and decreasing opioid consumption. The study underscores the importance of defining and capturing meaningful, patient-specific, and patient-reported outcomes, and constant evaluation and monitoring of a group's compliance with the program. The study represents the steppingstone for evaluation and improvement of a young ERAS program for spine surgery and serves as a roadmap for further initiatives and larger-scale studies.

Keywords: ASA = American Society of Anesthesiologists; AUC = area under the curve; DVT = deep vein thrombosis; ERAS = Enhanced Recovery After Surgery; ERSS = Enhanced Recovery After Spine Surgery; LITT = laser interstitial thermal therapy; LOS = length of stay; MEDD = morphine equivalent daily dose; MISS = minimally invasive spine surgery; NRS = numeric rating scale; POD = postoperative day; TIVA = total intravenous anesthesia; enhanced recovery; length of stay; opioid consumption; outcomes; postoperative pain; spine surgery.

MeSH terms

  • Analgesics, Opioid / therapeutic use*
  • Female
  • Humans
  • Length of Stay / statistics & numerical data*
  • Male
  • Pain Management*
  • Postoperative Period
  • Recovery of Function / drug effects*
  • Retrospective Studies
  • Spinal Diseases / surgery*

Substances

  • Analgesics, Opioid