Application of enhanced recovery after surgery in pediatric patients with obstructive sleep apnea-hypopnea syndrome

Background Enhanced Recovery After Surgery (ERAS) has demonstrated effectiveness in accelerating recovery and reducing complications across surgical fields, with limited application in Ear-Nose-Throat surgeries. Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS), a prevalent condition affecting pediatric patients, calls for innovative management due to its impact on health and the need for surgical interventions like tonsillectomy. Objective The present study aimed to investigate the efficacy of ERAS in pediatric patients with OSAHS. Methods Review and analyze 1100 cases of pediatric patients with OSAHS who underwent plasma-coblation tonsillectomy and adenoidectomy using nasal endoscopy from June 2016 to June 2022 in our hospital. Among these cases, a total of 564 patients were managed according to ERAS theory, while 536 patients were treated with classical theory. The incidence of preoperative discomfort, postoperative pain, bleeding, and other complications between the two groups were compared. Results ERAS group showed comparable preoperative-discomfort rates to the control ( P = 0.799). However, ERAS patients exhibited significantly lower pain scores at 24-, 48-, and 72-h post-operation ( P < 0.05). Mental state scores were similar between ERAS and control 4 h pre-surgery ( P > 0.05), but notably lower in ERAS at 30 min pre-op and 6-, 12-, and 24-h post-operation ( P < 0.05). ERAS had lower complication rates and intra/postoperative bleeding, quicker ambulation/oral intake, and shorter hospital stays than control ( P < 0.05). Conclusion ERAS management in patients with OSAHS resulted in notable reductions in postoperative pain and incidence of complications, along with improved postoperative recovery and shorter hospital stays.