Abstract：
Increasing evidence demonstrates the advantages of an enhanced recovery after surgery (ERAS) protocol; however, few studies have evaluated ERAS in pediatric patients. This study aimed to evaluate the effect of ERAS in pediatric patients with congenital scoliosis. Seventy pediatric patients with congenital scoliosis underwent posterior hemivertebra resection and fusion with pedicle screws and were prospectively randomly assigned to the ERAS group ( n = 35) and control group ( n = 35). ERAS management comprised 15 elements including a shortened fasting time, optimized anesthesia protocol, and multimodal analgesia. The control group received traditional perioperative management. Clinical outcome was evaluated by hospital stay, surgery-related indicators, diet, pain scores, laboratory tests, and complications. The surgical outcome showed a similar correction rate in the ERAS group (84.0%) and control group (89.0%; P = 0.471). The mean fasting time was significantly shorter in the ERAS group than in the control group. Compared with the control group, the ERAS group had significantly shorter mean times to postoperative hospital stay, first anal exhaust and defecation, significantly lower mean pain scores in the first 2 days postoperatively ( P < 0.05), and a significantly lower mean interleukin-6 concentration on postoperative day 1 ( P < 0.001). The incidence of complications was similar in the ERAS group and control group ( P > 0.05). The ERAS protocol is effective and safe for pediatric patients with congenital spinal deformity and may significantly improve the treatment efficacy compared with traditional perioperative management methods. Levels of Evidence: III.
摘要：
越来越多的证据表明，增强术后恢复（ERAS）方案的优势;然而，很少有研究在儿科患者中评估ERAS。本研究旨在评估ERAS在先天性脊柱侧凸患儿中的应用效果。70例先天性脊柱侧凸患儿接受了后路半椎体切除和椎弓根螺钉融合术，前瞻性随机分为ERAS组（n=35）和对照组（n=35）。ERAS管理包括15个要素，包括缩短禁食时间，优化的麻醉方案，和多模式镇痛。对照组采用传统的围手术期管理。通过住院时间评估临床结果，手术相关指标，饮食，疼痛评分,实验室测试,和并发症。ERAS组（84.0％）和对照组（89.0％；P=0.471）的手术结果相似。ERAS组的平均禁食时间明显短于对照组。与对照组相比,ERAS组术后平均住院时间明显较短，第一次肛门排气和排便，术后前2天的平均疼痛评分显着降低（P<0.05），术后第1天的平均白细胞介素-6浓度显着降低（P<0.001）。ERAS组和对照组并发症发生率相似(P>0.05)。ERAS方案对于先天性脊柱畸形患儿是有效和安全的，与传统的围手术期处理方法相比，可以显着提高治疗效果。证据水平：三。
