Enhanced Recovery After Surgery (ERAS) Protocol
Conditions
Brief summary
This prospective randomized controlled clinical trial aims to evaluate the effectiveness of Enhanced Recovery After Surgery (ERAS) protocols in patients undergoing elective hysterectomy. ERAS is an evidence-based perioperative approach designed to reduce surgical stress, accelerate recovery, and improve clinical outcomes. Participants will be randomized to receive either ERAS-based care or conventional perioperative management. The study will assess whether ERAS implementation reduces hospital stay and improves postoperative recovery without increasing complications.
Detailed description
Enhanced Recovery After Surgery (ERAS) protocols are structured, multidisciplinary perioperative care pathways developed to optimize surgical outcomes by minimizing physiological stress and promoting early recovery. These protocols include preoperative counseling, shortened fasting with carbohydrate loading, opioid-sparing anesthesia, early feeding, and early mobilization. Hysterectomy remains one of the most common gynecological procedures worldwide and is often associated with prolonged hospital stay and postoperative morbidity, particularly in resource-limited settings. While international evidence supports the benefits of ERAS in improving outcomes such as reduced length of hospital stay, improved pain control, and decreased complications, there is a need for locally generated data to validate its effectiveness in Egyptian tertiary healthcare settings. This study will be conducted at Kasr Al-Ainy Hospital, Cairo University, and will include women undergoing elective hysterectomy for benign or early-stage malignant gynecological conditions. Participants will be randomly assigned to either the ERAS group or the conventional care group. Outcomes will be assessed during hospitalization and up to 30 days postoperatively.
Interventions
DRUGdextrose (5%)
IV dextrose infusion (5%) 500 ml once ,2-3 hours before anesthesia
PROCEDUREERAS protocols
Reduced fasting Early oral feeding Early mobilization
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Women aged 18-70 years. * Undergoing elective total hysterectomy for benign or early stage malignant gynacological conditions . * ASA ( American Society of Anesthesiologists ) physical status I-II. * Able to provide informed consent.
Exclusion criteria
* Emergency hysterectomy * Advanced malignant requiring extensive debulking * Known bowel disease or previous bowel surgery ( crohn's disease , bowel obstruction ) * Significant cognitive impairment or psychiatric illness * Inability to follow ERAS protocol (e.g., cognitive impairment) * Refusal to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| length of hospital stay (LOS) | From day of surgery up to 7 postoperative days | Time from completion of surgery to hospital discharge readiness, measured in days. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| postoperative pain score | At 12 and 24 hours postoperatively | Postoperative pain intensity measured using the Visual Analog Scale (VAS), a 10-cm scale ranging from 0 (no pain) to 10 (worst imaginable pain). |
| time to first bowel movement | Up to 5 postoperative days | the interval (in hours) from completion of surgery to the first documented passage of stool." |
Countries
Egypt
Contacts
CONTACTEhab H Sorour, MD
CONTACTMohamed E El Mahy, MD
PRINCIPAL_INVESTIGATOREhab H Sorour, MD
Cairo University
Outcome results
None listed