Thyroid Diseases, Goiter, Thyroid Neoplasms
Conditions
Keywords
Enhanced recovery after surgery, ERAS, Multimodal perioperative care, Length of hospital stay, Thyroidectomy, Opioid-sparing multimodal analgesia
Brief summary
Thyroidectomy is generally considered a low-to-moderate risk operation; however, postoperative pain, nausea/vomiting, and prolonged hospital stays remain common issues. Enhanced Recovery After Surgery (ERAS) pathways aim to optimize perioperative care and accelerate recovery. This study evaluates the effectiveness and safety of a standardized ERAS pathway in patients undergoing elective thyroidectomy. The prospective ERAS cohort is compared with a historical control group receiving conventional care to assess the impact on the length of hospital stay, postoperative pain, opioid consumption, and complication rates.
Interventions
This incorporates standardized preoperative counseling, reduced fasting, multimodal opioid-sparing analgesia, total intravenous anesthesia, selective drain use, early oral intake and mobilization, and PTH-guided calcium supplementation
PROCEDUREConventional perioperative care
This often involves prolonged preoperative fasting, opioid-based analgesia, and delayed mobilization
Sponsors
Assiut University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged 18-75 years * ASA physical status I-III. * Scheduled for elective thyroidectomy for benign or malignant disease.
Exclusion criteria
* Re-operative thyroid surgery * Concomitant neck dissection * Inability to comply with the ERAS pathway
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Length of hospital stay | Up to 30 days post-surgery | Hours from surgery end to discharge |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pain scores | Assessed in the first 24 hours postoperatively | Mean Numeric Rating Scale (NRS-11; 0 = no pain to 10 = worst imaginable pain) at rest in 24 hours. NRS scores are categorized as mild (1-3), moderate (4-6), or severe (7-10). |
| Total opioid consumption | Within first 24 hours | Oral Morphine Milligram Equivalents (MME) |
| Postoperative nausea and vomiting (PONV) | Up to 24 hours postoperatively | Incidence of PONV |
| Rate of postoperative hypocalcemia | First 30 days from the surgery | Biochemical and symptomatic occurrences |
| 30-day unplanned readmission rate | Up to 30 days postoperative | Number of unplanned readmissions |
Countries
Egypt
Outcome results
None listed