Comparison of adapted enhanced recovery after surgery pathway vs. standard care in patients undergoing emergency laparotomy for perforation peritonitis- A Randomized controlled trial
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 120
- 试验地点
- 1
- 主要终点
- Lenth of hospital stay
研究概览
简要总结
Emergency laparotomies constitute majority of the
emergency surgical operations amongst which surgeries done for small bowel
pathologies account for 22 % to 33 % of the cases.Postoperative mortality rates
of 10-14 % have been reported following emergency procedures for small
bowel pathology in India.This indicates the dire need for revising the
perioperative care practices in the emergency setting. Enhanced Recovery After Surgery (ERAS) pathway, is an integrated
care pathway that utilizes multimodal evidence based approach to optimize patient’s
recovery.The purpose of these pathways is to use current evidence in a streamlined
multidisciplinary manner with the aim of minimizing surgical pain and enhancing
recovery, leading to fewer complications, more rapid hospital discharge and improved
overall outcomes.
The applicability of ERAS pathways has been tested in numerous elective procedures
but there is a dearth in the studies conducted in an emergency setting. Hence this study is planned to assess the feasibility of ERAS in patients undergoing
emergency surgery for perforation peritonitis.
研究设计
- 研究类型
- Interventional
- 分配方式
- Computer generated randomization
- 盲法
- Open Label
入排标准
- 年龄范围
- 18.00 Year(s) 至 99.00 Year(s)（—）
- 性别
- All
入选标准
- •All consecutive patients above 18 years of age, who present to the emergency surgical team with perforation peritonitis, diagnosed based on clinical examination and adjunct investigations and planned for emergency laparotomy after volume resuscitation.
排除标准
- •1.Age less than 18 years
- •Uncontrolled comorbid diseases.
- •Localized peritonitis
- •American Society of Anesthesiologists physical status class 4E
- •Patients with coagulopathy (INR .1.5 and platelet count < 1 lakh)
- •Patients on vasopressor or ventilator support
- •Septic shock
- •Associated psychiatric or neurological illnesses
- •Pregnant patients
- •Polytrauma patients with associated other intraabdominal organ injury.
结局指标
主要结局
Lenth of hospital stay
时间窗: from 4 days upto 2-3 weeks
次要结局
- To identify risk factors which are responsible for delayed discharge/ failure of(ERAS)
- Time elapsed until resumption of oral feeding(ï‚· Time for removal of nasogastric tube, drains and catheter)