Enhanced Recovery After Surgery (Eras) Protocol (Preoperative and Intraoperative Parameters) in Donor Hepatectomy: A Prospective Observational Study

Background: Enhanced Recovery After Surgery (ERAS) protocols have revolutionized perioperative care by optimizing patient outcomes, reducing complications and shortening hospital stays. This study evaluates the impact of perioperative anesthetic management on early recovery after donor hepatectomy within an ERAS framework. Methodology:Aprospective observational study was conducted from April 2023 to March 2025 at Mahatma Gandhi Medical College & Hospital, Jaipur. 74 patients aged 18-65 years (ASA I-III) undergoing elective hepatectomy were included. The study evaluated ERAS implementation feasibility, hospital stay duration, early recovery parameters, patient satisfaction, complications and readmission rates. Results: The mean age was 33.23 ± 9.64 years with 63.5% females and 36.5% males. Most patients (87.8%) were ASA-I. Right hepatectomy was performed in 93.2% of cases. The mean surgical duration was 487.27±86.91 minutes with average blood loss of 559.46 ± 229.51 ml. Normal recovery (<7 days) was achieved in 64.9% of patients. Intraoperative complications occurred in 12.2% and postoperative complications in 44.6% of patients. No 30-day readmissions occurred. Conclusion: ERAS-guided preoperative and intraoperative anesthetic management significantly supports early recovery after hepatic resections. The structured approach with multimodal analgesia, optimized preoperative and intraoperative monitoring and duration of surgery resulted in favorable outcomes with 64.9% of patients achieving normal recovery within seven days.