Secondary outcomes
We observed no significant differences between the two groups regarding
duration of the operation (defined as the time from intubation to
extubation), diminution in hemoglobin, fentanyl dosage, overall or
severe morbidity, readmission rate, or in-hospital costs (Table 3).
Patients in the intervention group exhibited a lower narcotic
consumption rate (1.4% in the full ERAS program compared with 17.4%
receiving limited ERAS management, P = .001), and reported that
improved postoperative pain management as denoted by NRS scores within
72 hours after surgery was significantly lower in the intervention group
than in the control arm. In both the groups, the NRS score was the
highest at 2 hours postoperatively and gradually diminished over time
(Table 3). Multivariate analysis showed that the use of preoperative
analgesics (B = 12.95; 95% CI, 4.28–39.17; P < .001)
was the only independent factor associated with better pain control
(defined as an NRS score ≤ 3 points) at 24 hours postoperatively.
There was no statistical difference in the overall PONV incidence
(38.6% in the intervention group versus 44.9% in the control arm,P = .447), or severe PONV incidence (defined as a PONV score ≥ 5
points; 8.6% versus 15.9%, respectively; P = .185).
Multivariate regression analysis identified the absence of previous PONV
history (B = 14.86; 95% CI, 1.50–146.85; P = .021), operation
duration < 3 hours (B = 5.85; 95% CI, 1.07–31.98; P =
.041), absence of narcotics (B = 4.23; 95% CI,1.11–16.15; P =
.035), and utilization of TIVA (B = 3.37; 95% CI, 0.85–13.40; P= .084) as the independent factors for improved PONV management.
Compared with patients in the control group, those in the full ERAS
program were more likely to produce early flatus: 775.0 min
(563.8–1004.8 min) versus 1022.5min (833.8–1248.8 min), respectively
(P < .001); they also enjoyed a better and faster
recovery as demonstrated by the QoR-15 scale on POD 3: 137.0
(127.3–141.0) in the intervention group compared with 130.0
(124.0–138.8) in the control group (P = .020).