Table 1 The specific measures of the different management models
From: Enhanced recovery after surgery in congenital duodenal obstruction
Measure | ERAS group (n = 46) | Control group (n = 36) |
|---|---|---|
Pre-operatively | ||
Publicity and education | Parents were informed of the implementation plan and goals of the ERAS model, and trained to participate in the postoperative care | Traditional health education was conducted by the nurses in the NICU ward to the parents concerning the condition, surgery, and care in the pediatric patient. |
Intra-operatively | ||
Mode of surgery | Laparoscopic exploration was conducted, and the malformed bowel segment was dragged out via the umbilicus with the conduction of the laparoscopic external anastomosis. | Laparoscopic exploration was conducted, and the malformed bowel segment was dragged out via the umbilicus with the conduction of the laparoscopic external anastomosis. |
Body temperature management | A variety of insulation measures such as pre-heating, increasing the temperature in the operating room, using a thermoregulator, and a heated bed were adopted to ensure that the core temperature of the pediatric patient during surgery was > 36 °C. | The pediatric patient was warmed with the heated bed to ensure that the core temperature was > 36 °C during surgery. |
Liquid management | The warmed isotonic compound electrolyte solution was infused at a controlled rate of 6–8 ml/(kg. h). | The normothermic isotonic compounded electrolyte solution was infused at a rate of 6–8 ml/(kg. h). |
Post-operatively | ||
Analgesia | Ultrasound-guided nerve block anesthesia was conducted with non-nutritive sucking of a soother for analgesia. | Ultrasound-guided nerve block anesthesia was conducted. |
Early-stage activities | After the condition stabilized (withdrawal of the ventilator and with stable vital signs) in the pediatric patient, the parents in the ERAS management group entered the NICU accompanied by the nursing staff of the management team with preliminary training to complete the basic nursing measures for the pediatric patient, including holding the child, measuring the temperature, feeding, patting the back, and observing the trans-cutaneous oxygen saturation, etc. with a duration of 3–4 h per day. | Postoperatively, the pediatric patient rest in bed and the nurse in the NICU ward completed basic care such as feeding, temperature measurement, and diaper changing. |