Implementation and impact of perioperative management based on ERAS philosophy in the robot-assisted surgery for thoracolumbar fracture
10.3969/j.issn.1672-8270.2025.07.011
- VernacularTitle:基于加速康复外科理念下围术期管理在机器人辅助胸腰椎骨折手术中的实施及影响
- Author:
Sujing PAN
1
;
Xiao QIAN
1
;
Ying YE
1
;
Haiwei ZHANG
1
Author Information
1. 南京医科大学第一附属医院麻醉与围术期医学科 南京 210029
- Publication Type:Journal Article
- Keywords:
Thoracolumbar fracture;
Enhanced recovery after surgery(ERAS);
Robot-assisted surgery;
Perioperative management
- From:
China Medical Equipment
2025;22(7):55-60
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the application effect of perioperative management based on enhanced recovery after surgery(ERAS)philosophy in the robot-assisted surgery for thoracolumbar fracture.Methods:This was a prospective random control trial(RCT).A total of 80 patients with thoracolumbar fracture admitted to Jiangsu Provincial People's Hospital from January 2020 to January 2025 were selected.They were divided into control group and ERAS group according to random number method,with 40 cases in each group.All of them adopted robot-assisted surgery for thoracolumbar fracture as the main therapeutic scheme.After surgery,the control group adopted routine perioperative management,and the ERAS group adopted perioperative management based on the ERAS philosophy.The postoperative recovery time of physiological function(the time for removing urinary catheter,time for eating,time for exhaling,time for getting out of bed,and length of hospital stay)between two groups were compared.The self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were applied to assess the levels of anxiety and depression of the patients in two groups before surgery and at the 1st d,5th d and 7th d after surgery.In addition,the pain score of visual analogue scale(VAS),the incidence of postoperative complication,the scores of psychological state before and at the 7th day after surgery,and patient's satisfaction for diagnosis and treatment during the length of hospital stay as the evaluation of Nursing Scale for Nursing Staff(NSNS)before discharge were compared between the two groups.Results:The time for removing urinary catheter,time for eating,time for exhaling,time for getting out of bed,and length of hospital stay of ERAS group were shorter than those of control group,and the differences were significant(t=3.508,9.171,5.423,10.983,6.675,P<0.05).Before surgery,there were not significant differences in VAS score,SAS score and SDS score between the two groups(P>0.05).The VAS scores at the 1st d,5th d and 7th d after surgery in ERAS group were significantly lower than those in control group(t=5.433,5.882,5.060,P<0.05).At the 7th d after surgery,the scores of SAS and SDS in ERAS group significantly decreased,which were significantly lower than those in control group(t=14.327,13.390,P<0.05).The incidence of postoperative complications in ERAS group was 7.50%(3/40),which was lower than 32.50%(13/40)in control group(x2=7.812,P<0.05).Satisfaction of patients in ERAS group was 95.00%,which was significantly higher than 77.50%in control group(x2=5.165,P<0.05).Conclusion:The perioperative management based on ERAS philosophy can contribute to promote the recovery of postoperatively physiological function,and relieve postoperative pain,and improve postoperatively negative emotional state,and reduce the incidence of postoperative complications,and enhance patient's satisfaction.