TY - JOUR
T1 - Pain management, fluid therapy and thromboprophylaxis after pancreatoduodenectomy
T2 - a worldwide survey among surgeons
AU - Groen, Jesse V.
AU - Henrar, Rutger B.
AU - Hanna Sawires, Randa G.
AU - AlEassa, Essa
AU - Martini, Chris H.
AU - Bonsing, Bert A.
AU - Vahrmeijer, Alexander L.
AU - Besselink, Marc G.
AU - Pecorelli, Nicolo
AU - Hackert, Thilo
AU - Ishizawa, Takeaki
AU - Miller, Timothy
AU - Mungroop, Timothy H.
AU - Samra, Jaswinder
AU - Sauvanet, Alain
AU - Adham, Mustapha
AU - Demartines, Nicolas
AU - Christophi, Chris
AU - Morris-Stiff, Gareth
AU - Mieog, J. Sven D.
N1 - Funding Information: The authors would like to thank all participating surgeons who completed the survey. The authors would also like to thank A. Hamming (Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands), J. Vuyk and A. Dahan (Department of Anaesthesiology, Leiden University Medical Centre, Leiden, The Netherlands) for their help in designing the survey. Publisher Copyright: © 2021 The Author(s)
PY - 2022/4/1
Y1 - 2022/4/1
N2 - Background: The aim of this survey was to assess practices regarding pain management, fluid therapy and thromboprophylaxis in patients undergoing pancreatoduodenectomy on a global basis. Methods: This survey study among surgeons from eight (inter)national scientific societies was performed according to the CHERRIES guideline. Results: Overall, 236 surgeons completed the survey. ERAS protocols are used by 61% of surgeons and respectively 82%, 93%, 57% believed there is a relationship between pain management, fluid therapy, and thromboprophylaxis and clinical outcomes. Epidural analgesia (50%) was most popular followed by intravenous morphine (24%). A restrictive fluid therapy was used by 58% of surgeons. Chemical thromboprophylaxis was used by 88% of surgeons. Variations were observed between continents, most interesting being the choice for analgesic technique (transversus abdominis plane block was popular in North America), restrictive fluid therapy (little use in Asia and Oceania) and duration of chemical thromboprophylaxis (large variation). Conclusion: The results of this international survey showed that only 61% of surgeons practice ERAS protocols. Although the majority of surgeons presume a relationship between pain management, fluid therapy and thromboprophylaxis and clinical outcomes, variations in practices were observed. Additional studies are needed to further optimize, standardize and implement ERAS protocols after pancreatic surgery.
AB - Background: The aim of this survey was to assess practices regarding pain management, fluid therapy and thromboprophylaxis in patients undergoing pancreatoduodenectomy on a global basis. Methods: This survey study among surgeons from eight (inter)national scientific societies was performed according to the CHERRIES guideline. Results: Overall, 236 surgeons completed the survey. ERAS protocols are used by 61% of surgeons and respectively 82%, 93%, 57% believed there is a relationship between pain management, fluid therapy, and thromboprophylaxis and clinical outcomes. Epidural analgesia (50%) was most popular followed by intravenous morphine (24%). A restrictive fluid therapy was used by 58% of surgeons. Chemical thromboprophylaxis was used by 88% of surgeons. Variations were observed between continents, most interesting being the choice for analgesic technique (transversus abdominis plane block was popular in North America), restrictive fluid therapy (little use in Asia and Oceania) and duration of chemical thromboprophylaxis (large variation). Conclusion: The results of this international survey showed that only 61% of surgeons practice ERAS protocols. Although the majority of surgeons presume a relationship between pain management, fluid therapy and thromboprophylaxis and clinical outcomes, variations in practices were observed. Additional studies are needed to further optimize, standardize and implement ERAS protocols after pancreatic surgery.
UR - http://www.scopus.com/inward/record.url?scp=85127961547&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.hpb.2021.09.006
DO - https://doi.org/10.1016/j.hpb.2021.09.006
M3 - Article
C2 - 34629261
SN - 1365-182X
VL - 24
SP - 558
EP - 567
JO - HPB
JF - HPB
IS - 4
ER -