Improving the outcome of pediatric emergency abdominal surgeries by application of enhanced recovery after surgery protocol

Introduction Pediatric emergency abdominal surgery is accompanied by high level of morbidity and mortality. Many protocols had been used to improve the outcome in these situations; from them fast track or enhanced recovery after surgery (ERAS) protocols gained high level of importance. Few studies investigated its application in emergency pediatric diseases.Aim of the work The aim of or work was to study the applicability and the outcome of ERAS protocol applied in emergency pediatric abdominal surgery.Material and Methods 60 pediatric patients with abdominal emergencies were randomly distributed into two groups. Group A was subjected to ERAS protocol and group B was managed by the conventional protocol, success was measured by Hannover criteria.Results Most of the parameters of the protocol were applied except for some of the preoperative items due to the nature of the situation. In comparison to the conventional protocol; ERAS protocol resulted in better outcome regarding better pain control, shorter hospital stay being 1.93±2.23 day in group A and 4.23±2.21 day in group B (P<0.001) and earlier return to full oral feeding within 2 days postoperative in 87% of patients in contrast to only 23 % in group B (P<0.001). More than 90 % of parents classified this management plan as excellent. Post-operative vomiting didn’t show significant difference between ERAS group and conventional group and didn’t affect the outcome significantly.Conclusion ERAS is applicable in emergency pediatric abdominal surgeries resulting in better outcome of this situations which have high rate of morbidity and mortality.