Enhanced Recovery After Surgery Protocol on Early Mobilization After Colorectal Surgery

Compliance With Enhanced Recovery After Surgery Protocol on Early Mobilization After Colorectal Surgery in Tertiary Hospital in Indonesia

Early mobilization is an important factor in increasing postoperative colorectal surgeries outcome. There are four components held by anesthesiologist in Enhanced Recovery After Surgery protocol for colorectal surgery in our hospital: post operative nausea and vomiting (PONV) prophylaxis, intraoperative fluid management, intraoperative multimodal analgesia, and postoperative opioid-free pain management. Although early mobilization affected by postoperative pain, vomiting and nausea, and fluid balance management, nonetheless, there is no clear evidence of how much each of these components will affect early mobilization.

Study Overview

• Status: Completed
• Conditions: Anesthesia; Enhanced Recovery After Surgery; Colorectal; Surgery-Complications; Early Mobilization
• Intervention / Treatment: Procedure: Early mobilization; Procedure: No early mobilization

Detailed Description

Early mobilization is an important factor in increasing postoperative colorectal surgeries outcome. There are four components held by anesthesiologist in ERAS protocol for colorectal surgery in our hospital: PONV prophylaxis, intraoperative fluid management, intraoperative multimodal analgesia, and postoperative opioid-free pain management. Although early mobilization affected by postoperative pain, vomiting and nausea, and fluid balance management, nonetheless, there is no clear evidence of how much each of these components will affect early mobilization. This study was a retrospective cohort study by collecting secondary data from patients underwent elective colorectal surgery in our hospital from January 2020 to December 2022. The outcomes assessed were early mobilization rate and factors affecting it (PONV prophylaxis, intraoperative fluid management, intraoperative multimodal analgesia, and postoperative opioid-free pain management).

• Study Type: Observational
• Enrollment (Actual): 343

Contacts and Locations

Study Locations

• Indonesia
  • DKI Jakarta
    • Jakarta Pusat, DKI Jakarta, Indonesia, 10430
      • Cipto Mangunkusumo Central National Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

All patients underwent colorectal surgery in Cipto Mangunkusumo Hospital during 2020 to 2022

Description

Inclusion criteria

• Patient underwent colorectal surgery in Cipto Mangunkusumo Hospital from 2020 to 2022
• Age 18-60 years old
• American Society of Anesthesiologist (ASA) physical status 1, 2, and 3

Exclusion criteria

• Patients who were not intubated on postoperative period
• Patients who had physical limitation during preoperative mobility test

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Early mobilization; Patients who achieved early mobilization after colorectal surgery	Procedure: Early mobilization; Patients who received early mobilization in postoperative period
No early mobilization; Patients who did not achieve early mobilization after colorectal surgery	Procedure: No early mobilization; Patients who did not receive early mobilization in postoperative period

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Early mobilization	Number of patients who can walk within 24 hours after surgery	Within 24 hours after surgery
PONV prophylaxis	Number of patients who received prophylaxis given for PONV	Given during intraoperative period
Multimodal analgesia	Number of patients who got multimodal analgesia, which consists of epidural anesthesia or peripheral nerve block	Given during intraoperative period
Intraoperative fluid management	Number of patients who achieved fluid balance of zero or near zero	Given during intraoperative period
Postoperative pain management	Number of patients who received postoperative pain management without opioid	Immediately after surgery until discharge, assessed until hospital discharge, up to 50 days

Collaborators and Investigators

• Sponsor: Indonesia University
• Investigators: Principal Investigator: Aldy Heriwardito, Consultant, Indonesia University

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2023
• Primary Completion (Actual): April 30, 2023
• Study Completion (Actual): April 30, 2023

Study Registration Dates

• First Submitted: July 31, 2023
• First Submitted That Met QC Criteria: September 30, 2023
• First Posted (Actual): October 4, 2023

Study Record Updates

• Last Update Posted (Actual): October 4, 2023
• Last Update Submitted That Met QC Criteria: September 30, 2023
• Last Verified: September 1, 2023

More Information

Terms related to this study

• Keywords: Enhanced Recovery After Surgery; pain management; fluid management; early mobilization; PONV prophylaxis
• Other Study ID Numbers: IndonesiaUAnes112

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No