Patients' opinions on enhanced recovery after surgery perioperative care principles: a questionnaire study

Anna Zychowicz, Magdalena Pisarska, Anna Łaskawska, Monika Czyż, Jan Witowski, Michał Kisielewski, Jan Kulawik, Andrzej Budzyński, Michał Pędziwiatr, Anna Zychowicz, Magdalena Pisarska, Anna Łaskawska, Monika Czyż, Jan Witowski, Michał Kisielewski, Jan Kulawik, Andrzej Budzyński, Michał Pędziwiatr

Abstract

Introduction: The enhanced recovery after surgery (ERAS) protocol relies on patients' compliance and their awareness of its principles. Patients' views on ERAS implementation have never been evaluated in Poland before.

Aim: To analyse patients' opinions about this protocol.

Material and methods: One hundred forty consecutive patients undergoing elective laparoscopic procedures in which ERAS was implemented were asked to join the study. Out of them, 120 fulfilled the trial criteria and were surveyed once before and twice after surgery. A 22-question survey about the patient's perception of ERAS principles was presented upon admission and on the day of discharge. A telephone follow-up was performed 2 weeks after discharge.

Results: Patients reported the need for being counselled by the anaesthetist/surgeon as the most important element of the protocol. Items such as being free of pain, being free of gastrointestinal symptoms, and being free of catheter were rated more highly preoperatively than on the day of discharge, whereas telephone check-up call, being able to drink and eat early after surgery, avoiding bowel preparation, avoiding preoperative fasting and reducing postoperative intravenous fluids were rated more highly on the day of discharge. Pain was still present in over half of patients two weeks after discharge. Only 4.76% of patients admitted in the telephone survey that they were afraid of early discharge. Shortening of the length of hospital stay thanks to ERAS was widely appreciated among all patients who did not find it necessary to spend a longer time in the hospital.

Conclusions: Polish patients approve the ERAS protocol as modern perioperative care. Patients emphasize the need for preoperative counselling and painless recovery.

Keywords: enhanced recovery after surgery; fast-track surgery; patients’ opinions; perioperative care.

Figures

Figure 1
Figure 1
Patients ratings of ERAS items importance and goals. Answers to questions marked with asterisk (*) and blue-coloured bars were statistically significant. Questions are listed in order of given score, descending
Figure 2
Figure 2
Rating of postoperative symptoms and difficulties in the group of patients on the day of discharge
Figure 3
Figure 3
Patients’ response to questions asked via telephone 2 weeks after discharge

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