adapted enhanced recovery after surgery pathway vs. standard care in patients undergoing emergency laparotomy for perforation peritonitis- Which is better?

Not yet recruiting

Conditions: Generalized (acute) peritonitis,

Registration Number: CTRI/2019/02/017537

Lead Sponsor: Jawaharlal Institute of Postgraduate Medical Education Research Government of India

Brief Summary: 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 patientâ€™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.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 120

Inclusion Criteria

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.

Exclusion Criteria

1.Age less than 18 years 2.
Uncontrolled comorbid diseases.
Localized peritonitis 4.
American Society of Anesthesiologists physical status class 4E 5.
Patients with coagulopathy (INR .1.5 and platelet count < 1 lakh) 6.
Patients on vasopressor or ventilator support 7.
Septic shock 8.
Associated psychiatric or neurological illnesses 9.
Pregnant patients 10.
Polytrauma patients with associated other intraabdominal organ injury.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Lenth of hospital stay	from 4 days upto 2-3 weeks

Secondary Outcome Measures

Name	Time	Method
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

Trial Locations

Locations (1): Jawaharlal Institute of Postgraduate Medical Education & Research, Government of India.
🇮🇳
Pondicherry, PONDICHERRY, India
Jawaharlal Institute of Postgraduate Medical Education & Research, Government of India.
🇮🇳Pondicherry, PONDICHERRY, India
Dr Pranavi A R
Principal investigator
8903307190
pranavi.ar@gmail.com