ERAS (enhanced recovery after surgery) programmas ietekme pacientiem gūžas locītavas endoprotezēšanas gadījumā
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Latvijas Universitāte
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lav
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Pētījuma aktualitāte: ERAS (Enhanced Recovery After Surgery) programma kļuvusi par nozīmīgu pieeju gūžas endoprotezēšanā. Tradicionālās metodes – ilgstošs gultas režīms un opioīdu monoterapija – ir saistītas ar augstāku komplikāciju risku un ilgāku atveseļošanos, kā arī lielāku slogu veselības aprūpes sistēmai. ERAS mērķis ir paātrināt atveseļošanos, samazinot hospitalizācijas ilgumu un uzlabojot pacientu aprūpes kvalitāti. Mērķis: Salīdzināt ERAS programmas efektivitāti ar standarta ārstēšanu pacientiem pēc gūžas locītavas endoprotezēšanas. Hipotēze: ERAS protokols uzlabo pēcoperācijas iznākumus. Metodoloģija: Prospektīvs, randomizēts, kontrolēts pētījums ar 115 pacientiem (vecumā 18–65 gadi), kuriem tika veikta plānveida vienpusēja gūžas endoprotezēšana. Pacienti tika sadalīti ERAS un kontroles grupās (1:1). Novērtēti rādītāji: hospitalizācijas ilgums, sāpes (NRS), morfīna patēriņš, HOOS, JR skala, pacientu apmierinātība. Rezultāti: Pētījumu pabeidza 90 pacienti (42 ERAS/48 KG). Hospitalizācijas ilgums vidēji bija 4 dienas abās grupās. ERAS grupai bija būtiski mazākas sāpes kustību laikā 4 stundas, nākamajā rītā un izrakstīšanās dienā. Morfīna patēriņš ERAS grupā bija ievērojami zemāks. HOOS, JR skalas uzlabojumi abās grupās, ar tendenci par labākiem rezultātiem ERAS grupā. Apmierinātība augsta visiem pacientiem. Netika konstatētas būtiskas komplikācijas. Secinājumi: Lai gan hospitalizācijas ilgums netika samazināts, ERAS programma būtiski samazināja sāpes, morfīna lietošanu un veicināja agrīnu funkcionālo atveseļošanos. Tā ir efektīva un droša pieeja gūžas endoprotezēšanas pacientiem.
Study Relevance: The Enhanced Recovery After Surgery (ERAS) program has become an important approach in hip replacement surgery. Traditional methods—such as prolonged bed rest and opioid monotherapy—are associated with higher complication risks and longer recovery, placing a greater burden on healthcare systems. The aim of ERAS is to accelerate recovery, reduce hospital stay duration, and improve the quality of patient care. Objective: To compare the effectiveness of the ERAS program with standard treatment in patients undergoing hip joint replacement. Hypothesis: The ERAS protocol improves postoperative outcomes. Methodology: A prospective, randomized, controlled trial involving 115 patients (aged 18–65) undergoing planned unilateral hip replacement due to osteoarthritis. Patients were randomly assigned to the ERAS or control group (1:1 ratio). Outcome measures included hospital stay duration, pain intensity (NRS), morphine consumption, HOOS, JR score, and patient satisfaction. Results: 90 patients completed the study (42 in the ERAS group, 48 in the control group). The average hospital stay was 4 days in both groups. Patients in the ERAS group experienced significantly lower pain during movement at 4 hours post-op, the following morning, and on discharge day. Morphine use was substantially lower in the ERAS group. HOOS, JR scores improved in both groups, with a trend favoring ERAS. Patient satisfaction was high in both groups. No major complications were observed. Conclusions: Although hospital stay duration was not reduced, the ERAS program significantly lowered pain levels, reduced opioid use, and promoted faster functional recovery. It is a safe and effective approach for hip replacement patients.
Study Relevance: The Enhanced Recovery After Surgery (ERAS) program has become an important approach in hip replacement surgery. Traditional methods—such as prolonged bed rest and opioid monotherapy—are associated with higher complication risks and longer recovery, placing a greater burden on healthcare systems. The aim of ERAS is to accelerate recovery, reduce hospital stay duration, and improve the quality of patient care. Objective: To compare the effectiveness of the ERAS program with standard treatment in patients undergoing hip joint replacement. Hypothesis: The ERAS protocol improves postoperative outcomes. Methodology: A prospective, randomized, controlled trial involving 115 patients (aged 18–65) undergoing planned unilateral hip replacement due to osteoarthritis. Patients were randomly assigned to the ERAS or control group (1:1 ratio). Outcome measures included hospital stay duration, pain intensity (NRS), morphine consumption, HOOS, JR score, and patient satisfaction. Results: 90 patients completed the study (42 in the ERAS group, 48 in the control group). The average hospital stay was 4 days in both groups. Patients in the ERAS group experienced significantly lower pain during movement at 4 hours post-op, the following morning, and on discharge day. Morphine use was substantially lower in the ERAS group. HOOS, JR scores improved in both groups, with a trend favoring ERAS. Patient satisfaction was high in both groups. No major complications were observed. Conclusions: Although hospital stay duration was not reduced, the ERAS program significantly lowered pain levels, reduced opioid use, and promoted faster functional recovery. It is a safe and effective approach for hip replacement patients.