Implementation of anesthesia-associated enhanced recovery protocols and postoperative outcomes in colorectal minimally invasive surgery: A retrospective cohort study

A BSTRACT Objectives: Higher adherence to enhanced recovery after surgery (ERAS) protocols improves outcomes, but real-world anesthetic ERAS data remain limited. This study examines anesthesia-influenced ERAS for colorectal surgery. Materials and Methods: Data from 131 patients receiving colorectal minimally invasive surgery (January 2020–November 2021) at Taipei Tzu Chi Hospital were analyzed. Patients were categorized as non-ERAS, pre-ERAS, or ERAS based on adherence to 25 ERAS components. Primary and secondary outcomes included hospital length of stay (LOS), pain, PONV, bowel recovery, and morphine use. Results: ERAS adherence rates were 91.8% (ERAS), 58.4% (pre-ERAS), and 40.0% (non-ERAS) ( P < 0.0001). The ERAS group had the shortest LOS (4.09 days, P < 0.0001), lowest pain and morphine use, reduced PONV (0%, P = 0.001), and fastest bowel recovery. Conclusion: Surgical ERAS care facilitates functional recovery, whereas anesthetic ERAS care further improves ERAS adherence and postoperative recovery by reducing pain, lowering PONV incidence, and accelerating the return of bowel function.