Enhanced Recovery After Surgery: A Path to Avoid Opioids

In an opioid-driven world, what are other options to help patients after surgery and spare them from touching opioids? Enhanced Recovery After Surgery (ERAS) is one method. ERAS utilizes non-opioid medications and techniques to control pain, shorten recovery period or length of stay in a hospital, and decrease complication rates after surgery. Here’s what you need to know about Enhanced Recovery After Surgery (ERAS).

What is ERAS?

ERAS is a patient-centered, evidence-based, pain management strategy employed by CRNAs anesthesia providers to avoid the need for opioids and improve patient outcomes. ERAS uses robust patient communication and opioid-sparing techniques such as regional anesthesia, peripheral nerve blocks, non-pharmacologic approaches, and non-opioid medications. While a traditional pain management pathway includes patient assessment followed by opioid/non-opioid prescribing and discharge, ERAS follows a much more effective path.

ERAS Pain Management Pathway

1. Preadmission – patient/family education; recovery and pain management planning
2. Preoperative – minimize fasting to reduce anxiety and pain perception and improve diet recovery
3. Intraoperative – administer analgesics and nerve blocks for pain and nausea/vomiting management
4. Postoperative – patient assessment, plan medication, and multimodal medication prescribing
5. Post-Discharge – education on anesthesia recovery, surgical procedure, and pain management
6. Continued Quality Improvement – analysis of compliance and outcomes to improve care

The Advantages of ERAS

Research has consistently shown that adoption of enhanced recovery (ER) leads to significant improvements in patient satisfaction, outcomes, and reduction in cost of care. To successfully integrate ER into practice, a structured, collaborative, multidisciplinary approach accompanied by education and awareness campaigns can be valuable. According to the Future of Anesthesia Care Today, ERAS improves the following outcomes:

• ERAS provides an average savings of $880 to $5,560 per patient.
• ERAS reduces patient length of stay by 3-4 days on average.
• ERAS reduces 30-day patient readmission rates and costs.
• ERAS helps patients return to normal activities more quickly.

To learn more about Enhanced Recovery After Surgery (ERAS), please contact us.

Sources:
AANA – Enhanced Recovery after Surgery
JAMA Network – Enhanced Recovery After Surgery
Future of Anesthesia Care Today

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