TRANSFORMING RECOVERY IN ABDOMINAL SURGERIES: A RANDOMIZED CONTROLLED TRIAL OF ERAS VERSUS CONVENTIONAL CARE

Abstract

Background: Enhanced Recovery After Surgery (ERAS) is a multimodal perioperative care protocol aimed at minimizing surgical stress, accelerating functional recovery, and reducing complications. While extensively validated in colorectal and hepatopancreatobiliary surgery in the West, adoption remains limited in many Indian centers. This randomized controlled trial compared ERAS with conventional perioperative care in elective abdominal surgeries at a South Indian tertiary care hospital.

Methods: Fifty patients undergoing elective abdominal surgery were randomized into two groups: ERAS (n=25) and conventional care (n=25). ERAS interventions included minimal preoperative fasting, early oral intake, multimodal analgesia, and early ambulation. Primary outcomes were length of hospital stay, time to oral intake, time to ambulation, and return of bowel function. Secondary outcomes included postoperative complications, analgesic requirement, and patient satisfaction. Statistical significance was defined as p <0.05.

Results: The ERAS group demonstrated significantly faster recovery:Length of stay: 3.6 ± 1.1 vs 6.2 ± 1.6 days (p<0.001),Time to oral intake: 6.5 ± 2.3 vs 22.8 ± 4.1 hours (p<0.001),Time to ambulation: 10.2 ± 3.1 vs 26.5 ± 5.8 hours (p<0.001),Return of bowel function: 16.5 ± 4.2 vs 32.2 ± 5.6 hours (p<0.001).Postoperative complications were lower in the ERAS group (16% vs 36%, p=0.041), with reduced analgesic requirement (2.1 ± 0.8 vs 4.5 ± 1.3 days, p<0.001). Patient satisfaction scores were higher in the ERAS group (8.6 ± 1.2 vs 6.9 ± 1.4, p<0.001).

Conclusion: ERAS protocols significantly enhanced postoperative recovery in abdominal surgeries by promoting early bowel function, ambulation, and nutrition, while reducing hospital stay, analgesic use, and complication rates. These findings are consistent with international evidence and highlight the feasibility and benefits of ERAS implementation in South Indian surgical practice.