Abstract：
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols have been implemented across surgical disciplines, including cranial vault remodeling for craniosynostosis. The authors aim to describe the implementation of an ERAS protocol for cranial vault remodeling procedures performed for patients with craniosynostosis at a tertiary care hospital.
METHODS: Institutional review board approval was received. All patients undergoing a cranial remodeling procedure for craniosynostosis at the authors\' institution over a 10-year period were collected (n = 168). Patient and craniosynostosis demographics were collected as well as operative details. Primary outcome measures were intensive care unit length of stay (ICU LOS) and narcotic usage. Chi squared and independent t-tests were employed to determine significance. A significance value of 0.05 was utilized.
RESULTS: During the time examined, there were 168 primary cranial vault remodeling procedures performed at the authors\' institution - all of which were included in the analysis. Use of the ERAS protocol was associated with decreased initial 24-hour morphine equivalent usage (p < 0.01) and decreased total morphine equivalent usage (p < 0.01). Patients using the ERAS protocol experienced a shorter ICU LOS (p < 0.01), but the total hospital length of stay was unchanged.
CONCLUSIONS: This study reiterates the benefit of developing and implementing an ERAS protocol for patients undergoing cranial vault remodeling procedures. The protocol resulted in an overall decreased ICU LOS and a decrease in narcotic use. This has implications for ways to maximize hospital reimbursement for these procedures, as well as potentially improve outcomes.
METHODS: Institutional review board approval was received. All patients undergoing a cranial remodeling procedure for craniosynostosis at the authors\' institution over a 10-year period were collected (n = 168). Patient and craniosynostosis demographics were collected as well as operative details. Primary outcome measures were intensive care unit length of stay (ICU LOS) and narcotic usage. Chi squared and independent t-tests were employed to determine significance. A significance value of 0.05 was utilized.
RESULTS: During the time examined, there were 168 primary cranial vault remodeling procedures performed at the authors\' institution - all of which were included in the analysis. Use of the ERAS protocol was associated with decreased initial 24-hour morphine equivalent usage (p < 0.01) and decreased total morphine equivalent usage (p < 0.01). Patients using the ERAS protocol experienced a shorter ICU LOS (p < 0.01), but the total hospital length of stay was unchanged.
CONCLUSIONS: This study reiterates the benefit of developing and implementing an ERAS protocol for patients undergoing cranial vault remodeling procedures. The protocol resulted in an overall decreased ICU LOS and a decrease in narcotic use. This has implications for ways to maximize hospital reimbursement for these procedures, as well as potentially improve outcomes.
摘要：
背景：已在外科学科中实施了增强术后恢复（ERAS）协议，包括颅骨前突的颅骨重建。作者旨在描述ERAS协议的实施，该协议用于在三级护理医院为颅骨滑脱症患者进行的颅骨重建手术。
方法：获得了机构审查委员会的批准。收集了所有在作者机构接受颅骨融合重塑手术的患者，为期10年（n=168）。收集患者和颅骨融合的人口统计学以及手术细节。主要结局指标是重症监护病房住院时间（ICULOS）和麻醉药的使用。采用卡方检验和独立t检验来确定显著性。使用0.05的显著性值。
结果：在检查的时间内，在作者机构进行了168例原发性颅骨穹顶重塑手术-所有这些手术都包括在分析中.ERAS方案的使用与初始24小时吗啡当量使用量减少(p<0.01)和总吗啡当量使用量减少(p<0.01)相关。使用ERAS协议的患者经历了较短的ICULOS（p<0.01），但总住院时间没有变化。
结论：本研究重申了开发和实施ERAS方案对接受颅穹窿重塑手术的患者的益处。该方案导致ICULOS总体降低和麻醉药使用减少。这对最大化医院报销这些程序的方法有影响，以及潜在的改善结果。
方法：获得了机构审查委员会的批准。收集了所有在作者机构接受颅骨融合重塑手术的患者，为期10年（n=168）。收集患者和颅骨融合的人口统计学以及手术细节。主要结局指标是重症监护病房住院时间（ICULOS）和麻醉药的使用。采用卡方检验和独立t检验来确定显著性。使用0.05的显著性值。
结果：在检查的时间内，在作者机构进行了168例原发性颅骨穹顶重塑手术-所有这些手术都包括在分析中.ERAS方案的使用与初始24小时吗啡当量使用量减少(p<0.01)和总吗啡当量使用量减少(p<0.01)相关。使用ERAS协议的患者经历了较短的ICULOS（p<0.01），但总住院时间没有变化。
结论：本研究重申了开发和实施ERAS方案对接受颅穹窿重塑手术的患者的益处。该方案导致ICULOS总体降低和麻醉药使用减少。这对最大化医院报销这些程序的方法有影响，以及潜在的改善结果。
