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Victor E. Staartjes, Marlies P. de Wispelaere, and Marc L. Schröder

E nhanced recovery after surgery (ERAS) represents a paradigm shift in surgical patient care and can result in substantial benefits in both clinical outcomes and cost-effectiveness through optimization of the postoperative recovery process. 11 While the first “fast-track” concepts arose around 1994, 8 , 11 the concept of ERAS was first formally introduced in 2001 by the ERAS Study Group, 4 focusing on both speed and quality of recovery. In 2009, the first guideline was published for colonic and rectal resections. 9 Protocols aimed at improving recovery after

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Michael Y. Wang, Peng-Yuan Chang, and Jay Grossman

T he Enhancing Recovery After Surgery (ERAS) movement began in Denmark as a practice concept integrating multidisciplinary, perioperative care programs. Previously known as “fast-track surgery” or “enhanced recovery programs,” it started to gain ground in the 1990s by aiming to reduce the length of hospitalization after elective abdominal surgery through integrated approaches to maintain cardiovascular, pulmonary, neurological, gastrointestinal, and endocrine homeostatic functions. 9 , 10 Traditionally, a patient's surgical journey has been broken into

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Ebru Tarıkçı Kılıç, Tuncay Demirbilek, and Sait Naderi

E nhanced recovery after surgery (ERAS) is a fast-track multimodal approach that is aimed at improving patient outcomes through all its protocols. It has a synergistic effect on pre-, intra-, and postoperative interventions leading to improvements in perioperative care and overall clinical outcomes. 6 , 7 Preoperative education helps to relieve anxiety and allows for earlier return to daily activities. This protocol ends prolonged fasting, mobility limitations, and fluid overload and has gained major popularity by lowering the recovery time, complication rates

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Vikram B. Chakravarthy, Hana Yokoi, Daniel J. Coughlin, Mariel R. Manlapaz, and Ajit A. Krishnaney

T he current healthcare climate focuses on evidence-based medicine that is efficient, safe, and cost-effective. Therefore, many surgical centers place greater emphasis on standardized protocols designed to maximize patient outcomes among all surgical specialties. Between 2004 and 2015, the number of elective lumbar fusions increased by 62.3% and was especially high among patients older than 65 years (138.7%). Overall hospital costs also increased by 177% during this period, exceeding $10 billion in 2015. 40 Enhanced recovery after surgery (ERAS) protocols

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Ellen M. Soffin, Douglas S. Wetmore, Lauren A. Barber, Avani S. Vaishnav, James D. Beckman, Todd J. Albert, Catherine H. Gang, and Sheeraz A. Qureshi

E nhanced recovery after surgery (ERAS) is a comprehensive perioperative care model that optimizes outcomes via standardized, evidence-based interventions. 13 A major goal of ERAS is to maintain organ homeostasis and minimize the surgical stress response, so that patients experience a more rapid return to baseline function after surgery. Within orthopedic surgery, ERAS protocols have been widely applied to elective total joint arthroplasty. 9 , 29 , 30 , 32 Consistent with reports from other surgical procedures, orthopedic ERAS protocols are associated with

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Yuan Wang, Bolin Liu, Tianzhi Zhao, Binfang Zhao, Daihua Yu, Xue Jiang, Lin Ye, Lanfu Zhao, Wenhai Lv, Yufu Zhang, Tao Zheng, Yafei Xue, Lei Chen, Eric Sankey, Long Chen, Yingxi Wu, Mingjuan Li, Lin Ma, Zhengmin Li, Ruigang Li, Juan Li, Jing Yan, Shasha Wang, Hui Zhao, Xude Sun, Guodong Gao, Yan Qu, and Shiming He

C onventional craniotomy is typically associated with significant physiological stressors and prolonged functional recovery. An excessive stress response can predispose patients to an increased risk of cardiovascular and cerebrovascular complications, nutrient malabsorption, and delayed convalescence. 33 With our increasing understanding of perioperative pathophysiology, the concept of enhanced recovery after surgery (ERAS), introduced by Kehlet in 1997, has been established in an effort to improve functional outcomes after surgery and decrease perioperative

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Zarina S. Ali, Tracy M. Flanders, Ali K. Ozturk, Neil R. Malhotra, Lena Leszinsky, Brendan J. McShane, Diana Gardiner, Kristin Rupich, H. Isaac Chen, James Schuster, Paul J. Marcotte, Michael J. Kallan, M. Sean Grady, Lee A. Fleisher, and William C. Welch

I n recent years, enhanced recovery after surgery (ERAS) protocols have emerged as multimodal approaches designed to improve clinical outcomes in surgical patients. ERAS engages all healthcare providers in a longitudinal fashion, with an underlying theme of reduction of the dramatic stress response due to surgery. Coordination among multiple teams (outpatient staff, anesthesia team, surgical team, in-house ward staff, etc.) and dedicated interventional education as well as engagement of patients is critical to ensure a unified approach to the patient’s surgical

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Zach Pennington, Ethan Cottrill, Daniel Lubelski, Jeff Ehresman, Nicholas Theodore, and Daniel M. Sciubba

I n an effort to reduce variability, improve outcomes, and reduce cost in spinal surgery, there has been a recent drive to identify care pathways that result in consistently good, cost-effective outcomes for patients. This drive has led to the development of Enhanced Recovery After Surgery (ERAS) pathways, which were first described as “fast-track surgery” in the cardiac surgery literature in the 1990s. 1 ERAS pathways are defined by the ERAS Society as any perioperative care pathway designed to accelerate patient recovery after major surgery. 2 Elements of

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Ellen M. Soffin, Douglas S. Wetmore, James D. Beckman, Evan D. Sheha, Avani S. Vaishnav, Todd J. Albert, Catherine H. Gang, and Sheeraz A. Qureshi

-characterized clinical strategies include the use of multimodal analgesia (MMA) and enhanced recovery after surgery (ERAS) initiatives to standardize care and improve outcomes while providing satisfactory perioperative pain control. MMA has been consistently demonstrated to minimize opioid consumption and related side effects and is considered a vital component of ERAS pathways. 39 Conversely, relatively little attention has been paid to multimodal anesthetic agents and whether multimodal anesthesia may also minimize opioid requirements and promote rapid recovery after surgery

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Juergen Konczalla, Volker Seifert, Juergen Beck, Erdem Güresir, Hartmut Vatter, Andreas Raabe, and Gerhard Marquardt

( Supplemental Material ). Only patients randomized within 48 hours were included in the meta-analysis. Every patient had to be younger than 61 years, and the majority of patients were not unconscious in these trials. Also, all patients with conditions that could confound treatment assessment (e.g., those who required resuscitation) as well as all patients who had bilateral fixed and dilated pupils were excluded. Results Outcome in the Earlier Period Patient characteristics are summarized in Table 1 . TABLE 1. Comparison of patient characteristics from the pre-coiling era