What's New In  |   November 2019
What’s New in Spine Surgery: Enhanced Recovery After Surgery
Author Affiliations
  • Rafi Avitsian, M.D., FASA
    Immediate Past President, Society for Neuroscience in Anesthesiology and Critical Care (SNACC)
    Committee on Neuroanesthesia
Article Information
Neurosurgical Anesthesia / What's New In
What's New In   |   November 2019
What’s New in Spine Surgery: Enhanced Recovery After Surgery
ASA Monitor 11 2019, Vol.83, 60-62.
ASA Monitor 11 2019, Vol.83, 60-62.
The recent shift in health care policy towards an emphasis on quality-based care and improved patient outcomes has renewed the neuro-anesthesiologists’ interest in enhanced recovery after surgery (ERAS) protocols. ERAS is an iterative, comprehensive, multi-disciplinary approach encompassing the entire perioperative period to maximize patient outcomes, safety and cost-effectiveness. It focuses on standardization of care, inclusion of evidence-based best practices, and individualized patient-centered care. ERAS programs from various surgical specialties have shown success in decreasing postoperative length of stay, complications and opioid use.1,2 
Over the last two decades, the volume of and costs related to spine surgery have increased dramatically. Between 2004 and 2015, the number of elective lumbar fusions increased by 62.3 percent and overall hospital costs increased by 177 percent. Estimated hospital costs exceeded $10 billion in 2015, with complication rates for deformity surgery reported as high as 30 percent.3,4  To mitigate perioperative risks in spine patients, many centers have developed ERAS protocols targeting perioperative factors shown to affect outcomes. In order to be successful, there should be a strong multidisciplinary partnership between anesthesiologists and other clinical departments and personnel, including spine surgeons, spine physician assistants and nurses, as well as physicians practicing geriatric medicine endocrinology, blood management, and acute pain management.
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