ERAS Versus Conventional Care Following Gynecological Laparoscopic Surgery
Enhanced Recovery After Surgery (ERAS) Versus Conventional Perioperative Care Following Gynaecological Laparoscopic Surgery: A Prospective Comparative Study
This prospective randomized comparative study aims to compare Enhanced Recovery After Surgery (ERAS) protocol versus conventional perioperative care in women undergoing benign gynecological laparoscopic surgery. The primary outcome is quality of recovery assessed by QoR-15 score at 24 hours. Secondary outcomes include hospital stay, pain scores, bowel function, ambulation, analgesic consumption, PONV, complications, readmission, patient satisfaction and hospital cost.
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
Laparoscopic surgery is the standard approach for many benign gynecological conditions due to less tissue trauma, less pain and faster recovery. However perioperative care practices vary significantly and affect recovery.
Enhanced Recovery After Surgery (ERAS) is a multidisciplinary evidence-based pathway designed to reduce surgical stress and accelerate recovery. ERAS includes preoperative counseling and avoidance of prolonged fasting with clear fluids up to 2 hours and carbohydrate loading, no routine mechanical bowel preparation, standardized anesthesia with multimodal opioid-sparing analgesia, goal-directed fluid therapy, active warming, postoperative nausea and vomiting prophylaxis, avoidance of drains, early oral intake, early mobilization and early urinary catheter removal.
This study will randomize 100 women aged 18 to 60 years with ASA I-III scheduled for benign gynecological laparoscopic surgery into two groups in 1 to 1 ratio using computer-generated randomization. Group A will receive ERAS pathway and Group B will receive conventional care including NPO after midnight, bowel preparation with Prepawest, conventional NSAID analgesia, delayed feeding until bowel sounds return, and catheter retention until discharge.
All patients will be followed for 30 days. Primary outcome is QoR-15 at 24 hours. Secondary outcomes include VAS pain at 6, 12 and 24 hours, time to flatus, bowel movement, oral intake, ambulation, total analgesic consumption, PONV, complications classified by Clavien-Dindo, 30-day readmission, patient satisfaction and total hospital cost.
Data will be analyzed using SPSS with t-test or Mann-Whitney for continuous variables and Chi-square or Fisher exact for categorical variables. P less than 0.05 is considered significant.
Tipo di studio
Iscrizione (Stimato)
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
- Nome: sara M Farouk, resident
- Numero di telefono: 0 11 59002779
- Email: sameha.18313614@med.aun.edu.eg
Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- Women aged 18-60 years
- Indicated for benign gynaecologic laparoscopic surgery
- ASA physical status I-III
- Ability to provide informed consent
Exclusion Criteria:
- Pregnancy
- Suspected gynecologic malignancy
- Conversion to laparotomy
- Severe systemic disease preventing ERAS implementation
- Inability to comply with follow-up
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Terapia di supporto
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
|
Sperimentale: ERAS Group
ERAS protocol with counseling avoidance of prolonged fasting carb loading multimodal analgesia early feeding early mobilization early catheter removal |
Comprehensive ERAS pathway For Arm: ERAS Group |
|
Comparatore attivo: Conventional Care Group
Conventional care with NPO after midnight bowel prep with Prepawest conventional NSAIDs delayed feeding catheter until discharge discharge by surgeon discretion |
Standard routine care For Arm: Conventional Care Group |
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Quality of Recovery-15 score at 24 hours
Lasso di tempo: At 24 hours after surgery
|
Quality of Recovery-15 score measured by QoR-15 questionnaire from 0 to 150 higher score means better recovery |
At 24 hours after surgery
|
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Length of postoperative hospital stay
Lasso di tempo: Up to 30 days
|
Length of stay measured in hours from end of surgery to discharge |
Up to 30 days
|
|
Postoperative pain score at 6 hours
Lasso di tempo: At 6 hours after surgery
|
Pain score measured by Visual Analogue Scale from 0 to 10 higher score means worse pain |
At 6 hours after surgery
|
|
Postoperative pain score at 12 hours
Lasso di tempo: At 12 hours after surgery
|
Pain score measured by Visual Analogue Scale from 0 to 10 higher score means worse pain |
At 12 hours after surgery
|
|
Postoperative pain score at 24 hours
Lasso di tempo: At 24 hours after surgery
|
Pain score measured by Visual Analogue Scale from 0 to 10 higher score means worse pain |
At 24 hours after surgery
|
|
Time to first flatus
Lasso di tempo: Up to 48 hours
|
Time to first flatus measured in hours from end of surgery |
Up to 48 hours
|
|
Time to first bowel movement
Lasso di tempo: Up to 48 hours
|
Time to first bowel movement measured in hours from end of surgery |
Up to 48 hours
|
|
Time to first oral intake
Lasso di tempo: Up to 48 hours
|
Time to first oral intake measured in hours from end of surgery |
Up to 48 hours
|
|
Time to first ambulation
Lasso di tempo: Up to 48 hours
|
Time to first ambulation measured in hours from end of surgery |
Up to 48 hours
|
|
Total analgesic consumption
Lasso di tempo: Within 24 hours after surgery
|
Total analgesic consumption in milligrams within first 24 hours |
Within 24 hours after surgery
|
|
Number of participants with postoperative nausea and vomiting
Lasso di tempo: Within 24 hours after surgery
|
Number of participants who develop postoperative nausea and vomiting |
Within 24 hours after surgery
|
|
Number of participants with postoperative complications
Lasso di tempo: Up to 30 days
|
Number of participants with postoperative complications classified by Clavien-Dindo classification |
Up to 30 days
|
|
Number of participants with 30-day readmission
Lasso di tempo: Up to 30 days
|
Number of participants requiring hospital readmission within 30 days |
Up to 30 days
|
|
Patient satisfaction score
Lasso di tempo: At 24 hours after surgery
|
Patient satisfaction score measured on 0 to 10 scale higher score means greater satisfaction |
At 24 hours after surgery
|
Collaboratori e investigatori
Sponsor
Investigatori
- Cattedra di studio: Mahmoud S Mohamed, prof, obstetrics and gynaecology Department, Assiut University Hospitals, Assiut, Egypt
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Completamento primario (Stimato)
Completamento dello studio (Stimato)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
- ERAS-GynLap-Assiut-28
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .