Regional Anaesthesia in Enhanced Recovery After Surgery Pathways – A Quintessential Component
Vol 2 | Issue 2 | July-December 2021 | Page 87-91 | Abhijit S. Nair, Sandeep Diwan
DOI: 10.13107/ijra.2021.v02i02.033
Authors: Abhijit S. Nair [1], Sandeep Diwan [2]
[1] Department of Anaesthesia, Ibra Hospital, Ministry of Health-Oman, Ibra, Sultanate of Oman.
[2] Department of Anaesthesia, Sancheti Hospital, Pune, Maharashtra, India.
Address of Correspondence
Dr. Abhijit S. Nair, Department of Anaesthesia, Ibra Hospital, Ministry of Health-Oman, Ibra-414, Sultanate of Oman.
E-mail: abhijitnair95@gmail.com
Introduction
Enhanced recovery after surgery (ERAS) is a multimodal, perioperative care pathway designed to achieve early recovery for patients undergoing major surgery. [1] Initially described by Henry Kehlet in 1995 for colonic surgeries, the enhanced recovery pathways have now evolved and are now validated for more than 30 different types of surgery which include but are not limited to emergency laparotomy, neonatal surgeries, and lower segment cesarean sections. [2] Not only is the patient benefited from this by having an enhanced recovery and early discharge from the hospital, the cost of treatment is reduced and also leads to more turnover of patients thereby reducing the waiting list of patients scheduled for various surgeries. [3]
References
1. Ljungqvist O, Scott M, Fearon KC. Enhanced Recovery After Surgery: A Review. JAMA Surg. 2017; 152:292-8.
2. https://erassociety.org/guidelines/list-of-guidelines/ Last accessed on 20th July,2021.
3. Joliat GR, Ljungqvist O, Wasylak T, Peters O, Demartines N. Beyond surgery: clinical and economic impact of Enhanced Recovery After Surgery programs. BMC Health Serv Res. 2018; 18:1008.
4. Mehdiratta L, Mishra SK, Vinayagam S, Nair A. Enhanced recovery after surgery (ERAS)…. still a distant speck on the horizon! Indian J Anaesth. 2021; 65:93-6.
5. Ljungqvist O, Hubner M. Enhanced recovery after surgery-ERAS-principles, practice and feasibility in the elderly. Aging Clin Exp Res. 2018; 30:249-252.
6. Helander EM, Webb MP, Bias M, Whang EE, Kaye AD, Urman RD. Use of Regional Anesthesia Techniques: Analysis of Institutional Enhanced Recovery After Surgery Protocols for Colorectal Surgery. J Laparoendosc Adv Surg Tech A. 2017; 27:898-902.
7. Thapa P, Euasobhon P. Chronic postsurgical pain: current evidence for prevention and management. Korean J Pain. 2018; 31:155-73.
8. Correll D. Chronic postoperative pain: recent findings in understanding and management. F1000Res. 2017; 6:1054.
9. Feldheiser A, Aziz O, Baldini G, Cox BP, Fearon KC, Feldman LS et al. Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 2: consensus statement for anaesthesia practice. Acta Anaesthesiol Scand. 2016; 60:289-334.
10. Kaye AD, Urman RD, Rappaport Y, Siddaiah H, Cornett EM, Belani K et al. Multimodal analgesia as an essential part of enhanced recovery protocols in the ambulatory settings. J Anaesthesiol Clin Pharmacol. 2019;35(Suppl 1):S40-S45.
11. Simpson JC, Bao X, Agarwala A. Pain Management in Enhanced Recovery after Surgery (ERAS) Protocols. Clin Colon Rectal Surg. 2019; 32:121-8.
12. Tan M, Law LS, Gan TJ. Optimizing pain management to facilitate Enhanced Recovery After Surgery pathways. Can J Anaesth. 2015; 62:203-18.
13. Beverly A, Kaye AD, Ljungqvist O, Urman RD. Essential Elements of Multimodal Analgesia in Enhanced Recovery After Surgery (ERAS) Guidelines. Anesthesiol Clin. 2017;35: e115-e143.
14. Dunkman WJ, Manning MW. Enhanced Recovery After Surgery and Multimodal Strategies for Analgesia. Surg Clin North Am. 2018; 98:1171-84.
15. Al-Mazrou AM, Kiely JM, Kiran RP. Epidural analgesia in the era of enhanced recovery: time to rethink its use? Surg Endosc. 2019; 33:2197-2205.
16. Borzellino G, Francis NK, Chapuis O, Krastinova E, Dyevre V, Genna M. Role of Epidural Analgesia within an ERAS Program after Laparoscopic Colorectal Surgery: A Review and Meta-Analysis of Randomised Controlled Studies. Surg Res Pract. 2016; 2016:7543684.
17. Rosen DR, Wolfe RC, Damle A, et al. Thoracic Epidural Analgesia: Does It Enhance Recovery? Dis Colon Rectum. 2018; 61:1403-9.
18. Koning MV, Teunissen AJW, van der Harst E, Ruijgrok EJ, Stolker RJ. Intrathecal Morphine for Laparoscopic Segmental Colonic Resection as Part of an Enhanced Recovery Protocol: A Randomized Controlled Trial. Reg Anesth Pain Med. 2018; 43:166-73.
19. Kjølhede P, Bergdahl O, Borendal Wodlin N, Nilsson L. Effect of intrathecal morphine and epidural analgesia on postoperative recovery after abdominal surgery for gynecologic malignancy: an open-label randomised trial. BMJ Open. 2019;9: e024484.
20. Tang JZJ, Weinberg L. A Literature Review of Intrathecal Morphine Analgesia in Patients Undergoing Major Open Hepato-Pancreatic-Biliary (HPB) Surgery. Anesth Pain Med. 2019;9: e94441.
21. Wainwright TW, Gill M, McDonald DA, et al. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Acta Orthop. 2020; 91:3-19.
22. Blocks such as iPACK and adductor canal block are preferred over femoral and sciatic nerve blocks after TKA as they do not interfere with early ambulation which is desirable after TKA.
23. Kumar L, Kumar AH, Grant SA, Gadsden J. Updates in Enhanced Recovery Pathways for Total Knee Arthroplasty. Anesthesiol Clin. 2018; 36:375-86.
24. Oseka L, Pecka S. Anesthetic Management in Early Recovery After Surgery Protocols for Total Knee and Total Hip Arthroplasty. AANA J. 2018; 86:32-9.
25. Edwards MD, Bethea JP, Hunnicutt JL, Slone HS, Woolf SK. Effect of Adductor Canal Block Versus Femoral Nerve Block on Quadriceps Strength, Function, and Postoperative Pain After Anterior Cruciate Ligament Reconstruction: A Systematic Review of Level 1 Studies. Am J Sports Med. 2020; 48:2305-13.
26. Hewson DW, Oldman M, Bedforth NM. Regional anaesthesia for shoulder surgery. BJA Educ. 2019; 19:98-104.
27. Diwan S, Nair A. Erector Spinae Plane Block for Proximal Shoulder Surgery: A Phrenic Nerve Sparing Block!. Turk J Anaesthesiol Reanim. 2020; 48:331-3.
28. Kim AJ, Yong RJ, Urman RD. The Role of Transversus Abdominis Plane Blocks in Enhanced Recovery After Surgery Pathways for Open and Laparoscopic Colorectal Surgery. J Laparoendosc Adv Surg Tech A. 2017; 27:909-14.
29. Akerman M, Pejčić N, Veličković I. A Review of the Quadratus Lumborum Block and ERAS. Front Med (Lausanne). 2018; 5:44.
30. Guffey R, Keane G, Ha AY, et al. Enhanced Recovery With Paravertebral and Transversus Abdominis Plane Blocks in Microvascular Breast Reconstruction. Breast Cancer (Auckl). 2020; 14:1178223420967365.
31. Rotstein D, Park C, Khaitov S, Dickstein E. Rectus sheath catheters-a novel approach to perioperative analgesia for colorectal surgery in an enhanced recovery after surgery (ERAS) protocol: a case series. Int J Colorectal Dis. 2019; 34:1345-8.
32. Bakshi S, Mapari A, Paliwal R. Ultrasound-guided rectus sheath catheters: A feasible and effective, opioid-sparing, post-operative pain management technique: A case series. Indian J Anaesth. 2015; 59:118-20.
33. El-Boghdadly K, Madjdpour C, Chin KJ. Thoracic paravertebral blocks in abdominal surgery – a systematic review of randomized controlled trials. Br J Anaesth. 2016; 117:297-308.
34. Niraj G, Kelkar A, Hart E, Horst C, Malik D, Yeow C, Singh B, Chaudhri S. Comparison of analgesic efficacy of four-quadrant transversus abdominis plane (TAP) block and continuous posterior TAP analgesia with epidural analgesia in patients undergoing laparoscopic colorectal surgery: an open-label, randomised, non-inferiority trial. Anaesthesia. 2014;
35. Mishriky BM, George RB, Habib AS. Transversus abdominis plane block for analgesia after Cesarean delivery: a systematic review and meta-analysis. Can J Anaesth. 2012; 59:766-78.
36. Fields AC, Weiner SG, Maldonado LJ, Cavallaro PM, Melnitchouk N, Goldberg J et al. Implementation of liposomal bupivacaine transversus abdominis plane blocks into the colorectal enhanced recovery after surgery protocol: a natural experiment. Int J Colorectal Dis. 2020; 35:133-8.
37. Marija T, Aleksandar D. Erector spinae plane block in various abdominal surgeries: A case series. Saudi J Anaesth. 2020; 14:528-30.
38. Hannig KE, Jessen C, Soni UK, Børglum J, Bendtsen TF. Erector Spinae Plane Block for Elective Laparoscopic Cholecystectomy in the Ambulatory Surgical Setting. Case Rep Anesthesiol. 2018; 2018:5492527.
39. Park S, Park J, Choi JW, et al. The efficacy of ultrasound-guided erector spinae plane block after mastectomy and immediate breast reconstruction with a tissue expander: a randomized clinical trial. Korean J Pain. 2021; 34:106-13.
40. ElHawary H, Joshi GP, Janis JE. Practical Review of Abdominal and Breast Regional Analgesia for Plastic Surgeons: Evidence and Techniques. Plast Reconstr Surg Glob Open. 2020;8: e3224.
41. Zhang Y, Liu T, Zhou Y, Yu Y, Chen G. Analgesic efficacy and safety of erector spinae plane block in breast cancer surgery: a systematic review and meta-analysis. BMC Anesthesiol. 2021; 21:59.
42. Chiu C, Aleshi P, Esserman LJ, et al. Improved analgesia and reduced post-operative nausea and vomiting after implementation of an enhanced recovery after surgery (ERAS) pathway for total mastectomy. BMC Anesthesiol. 2018; 18:41.
43. Parikh RP, Myckatyn TM. Paravertebral blocks and enhanced recovery after surgery protocols in breast reconstructive surgery: patient selection and perspectives. J Pain Res. 2018; 11:1567-81.
44. Afonso AM, Newman MI, Seeley N, et al. Multimodal Analgesia in Breast Surgical Procedures: Technical and Pharmacological Considerations for Liposomal Bupivacaine Use. Plast Reconstr Surg Glob Open. 2017;5: e1480.
45. Diwan S, Koh WU, Chin KJ, Nair A. Bilateral high thoracic continuous erector spinae plane blocks for postoperative analgesia in a posterior cervical fusion. Saudi J Anaesth. 2020; 14:535-7.
46. Qiu Y, Zhang TJ, Hua Z. Erector Spinae Plane Block for Lumbar Spinal Surgery: A Systematic Review. J Pain Res. 2020; 13:1611-9.
47. Chiu C, Aleshi P, Esserman LJ, et al. Improved analgesia and reduced post-operative nausea and vomiting after implementation of an enhanced recovery after surgery (ERAS) pathway for total mastectomy. BMC Anesthesiol. 2018; 18:41.
48. Garg R. Regional anaesthesia in breast cancer: Benefits beyond pain. Indian J Anaesth. 2017; 61:369-72.
| How to Cite this Article: Nair AS, Diwan S | Regional Anaesthesia in Enhanced Recovery After Surgery Pathways – A Quintessential Component | International Journal of Regional Anaesthesia | July-December 2021; 2(2): 87-91. |
