经皮内镜腰椎间盘切除术术后加速康复：减少阿片类药物使用、住院时间和成本。
Enhanced recovery after microdiscectomy: reductions in opioid use, length of stay and cost.
机构信息
Department of Orthopedics Xinqiao Hospital, Army Medical University, 183 Xinqiao Main Street, Shapingba, Chongqing, 400037, People's Republic of China.
Department of Spine surgery, Sixth Affiliated Hospital of Xinjiang Medical University, 39 Wuxing South Road, Tianshan District, Urumqi, Xinjiang, 830002, People's Republic of China.
出版信息
BMC Surg. 2023 Aug 29;23(1):259. doi: 10.1186/s12893-023-02130-3.
BACKGROUND
Enhanced recovery after surgery (ERAS) protocols are widely used worldwide. Recently, studies of the ERAS program in spinal surgery subspecialties have been reported. The aim of this study was to evaluate the impacts of ERAS in minimally invasive microdiscectomy (MD) surgery.
METHODS
This was a retrospective cohort study of patients undergoing MD at a single center. From March 2018 to March 2021, 286 patients were in the ERAS group. A total of 140 patients from March 2017 to February 2018 were in the conventional group. The outcomes included length of stay (LOS), the postoperative numeric rating scale (NRS), complications, 30-day readmission rate, 30-day reoperation rate and cost. Moreover, perioperative factors were also evaluated.
RESULTS
Compared with the conventional group, the LOS and cost were reduced in the ERAS group. There were no significant differences in the NRS, complication rate, 30-day readmission or reoperation rates between the groups. Furthermore, postoperative drainage volume, and postoperative opioid use were lower in the ERAS group.
CONCLUSIONS
The ERAS protocol for MD surgery reduces LOS, cost and opioid use and accelerates patient recovery.
背景
加速康复外科（ERAS）方案在全球范围内得到广泛应用。最近，有关脊柱外科亚专业中 ERAS 方案的研究已有报道。本研究旨在评估 ERAS 在微创经皮椎间孔镜髓核摘除术（MD）中的应用效果。
方法
这是一项单中心回顾性队列研究，纳入了在该中心接受 MD 手术的患者。2018 年 3 月至 2021 年 3 月，286 例患者被纳入 ERAS 组，2017 年 3 月至 2018 年 2 月的 140 例患者被纳入常规组。结局指标包括住院时间（LOS）、术后数字评分量表（NRS）评分、并发症、30 天再入院率、30 天再手术率和成本。此外，还评估了围手术期相关因素。
结果
与常规组相比，ERAS 组的 LOS 和成本降低。两组间 NRS 评分、并发症发生率、30 天再入院率或再手术率无显著差异。此外，ERAS 组术后引流量和术后阿片类药物使用量较低。
结论
MD 手术的 ERAS 方案可缩短 LOS、降低成本和减少阿片类药物使用，并加速患者康复。
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