Enhanced Recovery After Surgery Protocol on Early Mobilization After Colorectal Surgery

Study Overview
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Brief Summary
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Early mobilization is an important factor in increasing postoperative colorectal surgeries outcome. There are four components held by anesthesiologist in Enhanced Recovery After Surgery protocol for colorectal surgery in our hospital: post operative nausea and vomiting (PONV) prophylaxis, intraoperative fluid management, intraoperative multimodal analgesia, and postoperative opioid-free pain management. Although early mobilization affected by postoperative pain, vomiting and nausea, and fluid balance management, nonetheless, there is no clear evidence of how much each of these components will affect early mobilization.

Detailed Description
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Early mobilization is an important factor in increasing postoperative colorectal surgeries outcome. There are four components held by anesthesiologist in ERAS protocol for colorectal surgery in our hospital: PONV prophylaxis, intraoperative fluid management, intraoperative multimodal analgesia, and postoperative opioid-free pain management. Although early mobilization affected by postoperative pain, vomiting and nausea, and fluid balance management, nonetheless, there is no clear evidence of how much each of these components will affect early mobilization. This study was a retrospective cohort study by collecting secondary data from patients underwent elective colorectal surgery in our hospital from January 2020 to December 2022. The outcomes assessed were early mobilization rate and factors affecting it (PONV prophylaxis, intraoperative fluid management, intraoperative multimodal analgesia, and postoperative opioid-free pain management).

Official Title
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Compliance With Enhanced Recovery After Surgery Protocol on Early Mobilization After Colorectal Surgery in Tertiary Hospital in Indonesia

Conditions
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Enhanced Recovery After Surgery, Anesthesia, Surgery-Complications, Colorectal, Early Mobilization

Intervention / Treatment
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* Procedure: Early mobilization
* Procedure: No early mobilization


Participation Criteria
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Eligibility Criteria
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Inclusion criteria Patient underwent colorectal surgery in Cipto Mangunkusumo Hospital from 2020 to 2022 Age 18-60 years old American Society of Anesthesiologist (ASA) physical status 1, 2, and 3 Exclusion criteria Patients who were not intubated on postoperative period Patients who had physical limitation during preoperative mobility test

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Early mobilization<br>Patients who achieved early mobilization after colorectal surgery | Procedure: Early mobilization<br>* Patients who received early mobilization in postoperative period<br>|
| No early mobilization<br>Patients who did not achieve early mobilization after colorectal surgery | Procedure: No early mobilization<br>* Patients who did not receive early mobilization in postoperative period<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Early mobilization | Number of patients who can walk within 24 hours after surgery | Within 24 hours after surgery | 
| PONV prophylaxis | Number of patients who received prophylaxis given for PONV | Given during intraoperative period | 
| Multimodal analgesia | Number of patients who got multimodal analgesia, which consists of epidural anesthesia or peripheral nerve block | Given during intraoperative period | 
| Intraoperative fluid management | Number of patients who achieved fluid balance of zero or near zero | Given during intraoperative period | 
| Postoperative pain management | Number of patients who received postoperative pain management without opioid | Immediately after surgery until discharge, assessed until hospital discharge, up to 50 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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early mobilization, Enhanced Recovery After Surgery, PONV prophylaxis, fluid management, pain management