ArticleSurgical endoscopy2020
Reduction of opioid use after implementation of enhanced recovery after bariatric surgery (ERABS).
Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 43 citations in OpenAlex.
- Utilization and evolving prescribing practice of opioid and non-opioid analgesics in patients undergoing lymphadenectomy for cutaneous malignancy.Journal of surgical oncology · 2022Trial
- Combined opioid free and loco-regional anaesthesia enhances the quality of recovery in sleeve gastrectomy done under ERAS protocol: a randomized controlled trial.BMC anesthesiology · 2022Trial
- Enhanced Recovery for Patients Undergoing Metabolic Bariatric Surgery in a Community Hospital: A Retrospective Pre-Post Quality Improvement Study.Obesity surgery · 2026Article
- Perioperative Enhanced Recovery After Surgery (ERAS) Clinical Pathway for Unilateral Biportal Endoscopy with Unilateral Laminotomy for Bilateral Decompression.Orthopaedic surgery · 2025Article
- Outcomes comparison for same-day laparoscopic Roux-en-Y gastric bypass: a propensity score matched analysis utilizing the MBSAQIP PUF.Surgical endoscopy · 2025Article
- Implementation of updated enhanced recovery after bariatric surgery guidelines: adapted protocol in a single tertiary center.Updates in surgery · 2024Observational
- Implementing novel modalities into an institutional enhanced recovery after bariatric surgery (ERABS) protocol.Surgical endoscopy · 2023Article
- Implementation of a standardized multimodal pain regimen significantly reduces postoperative inpatient opioid utilization in patients undergoing bariatric surgery.Surgical endoscopy · 2023Article
- Comparison of the Effects of Special Care Enhanced Recovery and Conventional Recovery Methods after Mini Omega Gastric Bypass.Advanced biomedical research · 2023Article
- Enhanced recovery after bariatric surgery: an Italian consensus statement.Surgical endoscopy · 2022Article
- Prescriptions for pain medication before and after bariatric surgery.Surgical endoscopy · 2022Article
- Outcomes of Bariatric Surgery in Patients on Chronic Opioids: Can Bariatric Surgery Assist with Decreasing Long-term Opioid Utilization?Obesity surgery · 2022Article
- Preoperative opioid use is associated with increased risk of postoperative complications within a colorectal-enhanced recovery protocol.Surgical endoscopy · 2021Article
- Bariatric Enhanced Recovery Protocol: a Community Quality Perspective.Obesity surgery · 2021Article
- Optimizing Perioperative Use of Opioids: A Multimodal Approach.Current anesthesiology reports · 2020Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnhanced recovery after surgery (ERAS) protocols have been extensively proven in lower gastrointestinal surgery to decrease postoperative physiologic stress and length of stay (LOS). ERAS in bariatric surgery (ERABS) varies immensely from each program with inconsistent results with a predominant goal of reducing LOS. Our focus in implementing enhanced recovery after bariatric surgery (ERABS) protocols is aimed at reducing postoperative pain and opioid use.
methodsThis is a retrospective review of patients who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (VSG) at a single high-volume center from June 2016 to October 2017. Patients on previous standard protocol were categorized into "Pre-Liposomal Bupivacaine (LB) group." After routine use of Exparel™, patients were grouped into "LB group." After ERABS protocol was initiated, patients were categorized into "ERABS/LB group." Postoperative opioids were converted to morphine equivalents units (MEU); pain scores, LOS, and 30-day outcomes were analyzed using combination of t test and Mann-Whitney U.
resultsA total of 1340 patients were included in the study: 304 patients in pre-LB group; 754 patients in LB group, and 282 patients in ERABS/LB group. Total hospital opioid use was 58.6 MEU in pre-LB, 40.8 MEU in LB, and 23.8 MEU in ERABS/LB (p = 0.01). ERABS/LB group found a 59.5% decline in MEU requirements compared to pre-LB (p < 0.001) and 44.9% of patients did not require any additional narcotics on the floor compared to 0% in pre-LB group (p < 0.001). ERABS/LB LOS was an average of 1.48 days compared to 1.54 days in pre-LB group (p = 0.03) with an overall decrease of 3.74% in readmission rates (p = 0.03).
conclusionsImplementation of ERABS significantly reduced postoperative opioid use, LOS, and readmissions. With ERABS, a more profound effect was observed than simply adding Exparel™ to preexisting protocols. Almost half of these patients did not require narcotics while recovering on the surgical floor. More studies are required to assess the true effect of ERABS without use of Exparel™.
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