Effect of enhanced recovery after surgery on older patients undergoing transvaginal pelvic floor reconstruction surgery: a randomised controlled trial

Abstract Background Prospective trial evidence is lacking regarding the application of enhanced recovery after surgery (ERAS) in transvaginal pelvic floor reconstruction surgery among older patients. Our study aimed to investigate whether implementing the ERAS protocol could enhance post-operative r...

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Main Authors: Xuezhu Huang, Sisi Deng, Xiaofeng Lei, Shentao Lu, Ling Dai, Chunyan She
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Medicine
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Online Access:https://doi.org/10.1186/s12916-025-03880-y
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author Xuezhu Huang
Sisi Deng
Xiaofeng Lei
Shentao Lu
Ling Dai
Chunyan She
author_facet Xuezhu Huang
Sisi Deng
Xiaofeng Lei
Shentao Lu
Ling Dai
Chunyan She
author_sort Xuezhu Huang
collection DOAJ
description Abstract Background Prospective trial evidence is lacking regarding the application of enhanced recovery after surgery (ERAS) in transvaginal pelvic floor reconstruction surgery among older patients. Our study aimed to investigate whether implementing the ERAS protocol could enhance post-operative recovery in this patient population. Methods Older patients undergoing elective transvaginal pelvic floor reconstruction surgery were randomly assigned to either the ERAS group or the conventional group. The primary outcome was post-operative length of stay (LOS). The secondary outcomes encompassed other post-operative recovery metrics, post-operative pain within 30 days, the occurrence of complications, the peri-operative blood test and cognitive function. Results A cohort of 100 patients was enrolled. Implementation of the ERAS protocol significantly reduced the duration of post-operative LOS (74.00 (69.00, 96.00) vs. 65.00 (59.00, 78.25) h, P < 0.01). Additionally, the ERAS protocol significantly reduced the duration of the first oral intake post-operatively (5.00 (2.50, 7.00) vs. 3.00 (2.00, 4.00) h, P = 0.01), and reduced rest and movement-related pain within 48 h post-operatively, effects that persisted through the 7-day follow-up period. It also shortened the duration of post-operative laryngeal mask airway support and promoted opioid-sparing. Moreover, the incidence and severity of post-operative nausea and vomiting (PONV) were significantly lower in the ERAS group compared to the conventional group at 12 h post-operatively. Conclusions Implementation of the ERAS protocol can expedite post-operative recovery in older patients undergoing transvaginal pelvic floor reconstruction surgery, achieve opioid-sparing, alleviate pain post-operatively, and decrease the incidence of complications. Trial registration This study was retrospectively registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2400084608). The date of first registration was 21/05/2024.
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spelling doaj-art-6f41c1390ccd409aad09be13ae53d3202025-02-02T12:28:16ZengBMCBMC Medicine1741-70152025-01-0123111210.1186/s12916-025-03880-yEffect of enhanced recovery after surgery on older patients undergoing transvaginal pelvic floor reconstruction surgery: a randomised controlled trialXuezhu Huang0Sisi Deng1Xiaofeng Lei2Shentao Lu3Ling Dai4Chunyan She5Department of Anaesthesiology, Women and Children’s Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children)Department of Anaesthesiology, Women and Children’s Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children)Department of Anaesthesiology, Women and Children’s Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children)Department of Gynaecology and Obstetrics, Women and Children’s Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children)Department of Gynaecology and Obstetrics, Women and Children’s Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children)Department of Gynaecology and Obstetrics, Women and Children’s Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children)Abstract Background Prospective trial evidence is lacking regarding the application of enhanced recovery after surgery (ERAS) in transvaginal pelvic floor reconstruction surgery among older patients. Our study aimed to investigate whether implementing the ERAS protocol could enhance post-operative recovery in this patient population. Methods Older patients undergoing elective transvaginal pelvic floor reconstruction surgery were randomly assigned to either the ERAS group or the conventional group. The primary outcome was post-operative length of stay (LOS). The secondary outcomes encompassed other post-operative recovery metrics, post-operative pain within 30 days, the occurrence of complications, the peri-operative blood test and cognitive function. Results A cohort of 100 patients was enrolled. Implementation of the ERAS protocol significantly reduced the duration of post-operative LOS (74.00 (69.00, 96.00) vs. 65.00 (59.00, 78.25) h, P < 0.01). Additionally, the ERAS protocol significantly reduced the duration of the first oral intake post-operatively (5.00 (2.50, 7.00) vs. 3.00 (2.00, 4.00) h, P = 0.01), and reduced rest and movement-related pain within 48 h post-operatively, effects that persisted through the 7-day follow-up period. It also shortened the duration of post-operative laryngeal mask airway support and promoted opioid-sparing. Moreover, the incidence and severity of post-operative nausea and vomiting (PONV) were significantly lower in the ERAS group compared to the conventional group at 12 h post-operatively. Conclusions Implementation of the ERAS protocol can expedite post-operative recovery in older patients undergoing transvaginal pelvic floor reconstruction surgery, achieve opioid-sparing, alleviate pain post-operatively, and decrease the incidence of complications. Trial registration This study was retrospectively registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2400084608). The date of first registration was 21/05/2024.https://doi.org/10.1186/s12916-025-03880-yPelvic organ prolapseGynaecological surgeryAgedEnhanced recovery after surgeryLength of stayPain
spellingShingle Xuezhu Huang
Sisi Deng
Xiaofeng Lei
Shentao Lu
Ling Dai
Chunyan She
Effect of enhanced recovery after surgery on older patients undergoing transvaginal pelvic floor reconstruction surgery: a randomised controlled trial
BMC Medicine
Pelvic organ prolapse
Gynaecological surgery
Aged
Enhanced recovery after surgery
Length of stay
Pain
title Effect of enhanced recovery after surgery on older patients undergoing transvaginal pelvic floor reconstruction surgery: a randomised controlled trial
title_full Effect of enhanced recovery after surgery on older patients undergoing transvaginal pelvic floor reconstruction surgery: a randomised controlled trial
title_fullStr Effect of enhanced recovery after surgery on older patients undergoing transvaginal pelvic floor reconstruction surgery: a randomised controlled trial
title_full_unstemmed Effect of enhanced recovery after surgery on older patients undergoing transvaginal pelvic floor reconstruction surgery: a randomised controlled trial
title_short Effect of enhanced recovery after surgery on older patients undergoing transvaginal pelvic floor reconstruction surgery: a randomised controlled trial
title_sort effect of enhanced recovery after surgery on older patients undergoing transvaginal pelvic floor reconstruction surgery a randomised controlled trial
topic Pelvic organ prolapse
Gynaecological surgery
Aged
Enhanced recovery after surgery
Length of stay
Pain
url https://doi.org/10.1186/s12916-025-03880-y
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