Outcome of Implementing Enhanced Recovery Protocol after Laparotomy Surgery

Background: The postoperative period following laparotomy surgery presents many challenges
to patients, clinicians, and nurses. Enhanced Recovery after Surgery (ERAS) Protocol is an evidence-
based intervention that aims to advance recovery for surgical patients, even though such protocols
introduced across the globe, comprehensive implementation are not common. Research aimed to study
the effect of implementing enhanced recovery protocol after laboratomy surgery on patients’ daily living
activities, post-operative functional outcome ability, patient satisfaction & length of hospital stay of the
study group compared to the control group. Methods: A quasi-experimental research design, with pre-
post-test was used. The study was conducted in New Surgery Building, Zagazig University Hospitals on
212 Patients who undergoing laparotomy surgery. The subjects were randomly enrolled at control and
study groups. Tools: an interviewing questionnaire that included five parts: demographic data, activities
of daily living scale, functional abilities scale, patient satisfaction questionnaire, and surgical pain scales.
Results: The total activities of daily living mean scores of the study group at 12 to 24 hours post-surgery
were 10.15±2.75 and 14.32±2.30, while in the control group were 7.68±1.93 and 11.38±3.14,
respectively, patients in study group were less suffering from pain & not needs an analgesic compared
to controlled group, the total functional outcome abilities of the study group at 8-12 hours and at 24 hours
post-surgery mean scores were 7.62±1.77 and 8.19±1.59, while the control group were 6.83±0.97 and
7.90±1.22 respectively, 71.7% of patients in the study group were satisfied at discharge, while only
24.5% of patients in the control group ,a highly positive correlation between activities of daily living,
functional outcome abilities, and patient satisfaction mean score of length of stay at the hospital at the
control study was 9.71, while the study group was 7.32 . By comparing mean scores of studied groups, a
statistically significantly difference were detected related to all study variables (P<0.05). Conclusion:
This study highlighted the application of ERAS protocol is associated with improving daily living
activity for patients post laparotomy surgery, decreasing the length of hospital stay as well as needing to
pain analgesic and increasing patients’ satisfaction. Researchers strengthen that adherence to ERAS
protocol guidelines improves postoperative functional outcomes among postoperative patients.
Recommendation: A standardized ERAS programs should be implemented in future in major surgical
specialties & must foster researchers as well as hospitals on this important topic