Comparison of enhanced recovery after surgery and conventional anaesthesia techniques on post-operative recovery in patients undergoing endoscopic endonasal skull base surgeries: A prospective randomised study.

BACKGROUND AND AIMS: Enhanced recovery after surgery (ERAS) is increasingly adopted in neuroanaesthesia, yet its application in endoscopic skull-base surgery remains unestablished. This prospective randomised study evaluated the effectiveness of ERAS in endoscopic skull-base surgeries.

METHODS

Sixty participants undergoing endoscopic skull-base surgery were randomised into either the ERAS group or the conventional anaesthetic technique (CAT) group. The primary objective was to compare the quality of post-operative recovery using the Quality of Recovery (QoR)-15 scoring system between the two groups at 24 hours post-operatively. The secondary objectives included comparing the days to ambulation, hospital stay, pain intensity, and patient satisfaction scores.

RESULTS

There was no significant difference in the mean QoR15 (± standard deviation) score between the groups [ERAS vs CAT, 98.40 ± 4.45 vs 96.56 ± 4.40, 95% confidence interval (-.45, 4.123), P = 0.114]. The days to ambulation showed a significant difference between ERAS and CAT (2.30 ± 0.535 vs 3.30 ± 0.915; P < 0.001), but the duration of hospital stay was not significantly different (ERAS vs CAT, 5.20 ± 0.761 vs 5.47 ± 0.86; mean difference = -0.26; P = 0.209). Pain scores were lower in the ERAS group from 1 to 12 hours after surgery (P < 0.001), but no significant difference was observed from 18 to 24 hours. The ERAS group had lower patient satisfaction scores (1.63 ± 0.490 vs 2.00 ± 0.694; P = 0.022), with lower scores indicating greater satisfaction.

CONCLUSION

ERAS offers early ambulation, reduced immediate post-operative pain, and higher patient satisfaction compared to CAT in endoscopic skull-base surgeries. However, it shows no difference in post-operative recovery and overall hospital stay compared to CAT.