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ABSTRACT BACKGROUND: Enhanced recovery after surgery (ERAS) protocols have been widely studied in elective abdominal surgeries and have shown better outcomes. However the utility of these protocols in emergency abdominal surgeries has not been widely investigated.
OBJECTIVE: To study the outcomes of application of ERAS protocols in patients undergoing perforated duodenal ulcers repairs in emergency abdominal surgeries.
METHODS: This randomized controlled trial was conducted in Surgical Unit 1 BBH from August 2018 to December 2019 with a total sample size of 36 patients with the diagnosis of perforated duodenal ulcer. Patients were randomly divided in two groups. Group A consisted of early oral feeding group and group B consisted of traditional postoperative care group. Outcome results studied were the length of hospital stay, duodenal repair site leak, severity of pain (VAS score) and duration of post-operative ileus. Results were analysed on SPSS version 20 and chi-square and independent t-test were applied.
KEY WORDS: Perforated duodenal ulcer, ERAS protocol, randomized controlled trial, duodenal repair site leak, length of hospital stay, VAS score, post-operative ileus
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Early oral feeding group(A) | Experimental | Patients admitted in the HDU postoperatively.NG tube and foley's catheter removed within 12 hours and patients allowed oral sips on day 1 with gradual shift to liquid diet after 12 hrs and semisolid food started after 24 hours later.Patients were given i/v antibiotics,painkillers and i/v PPIs and shifted to oral pain killers on 2nd POD. |
|
| Traditional postoperative care group(B) | No Intervention | Patients in this group were managed traditionally |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Early oral feeding/Enhanced recovery after surgery protocols | Dietary Supplement | Early oral feeding refers to NG tube and foley's catheter removed within 12 hours and patients allowed oral sips on day 1 with gradual shift to liquid diet after 12 hrs and semisolid food started after 24 hours later.Patients were given i/v antibiotics,painkillers and i/v PPIs and shifted to oral pain killers on 2nd POD. |
| Measure | Description | Time Frame |
|---|---|---|
| Length of hospital stay | Length of hospital stay is defined as duration of single episode of hospitalization. Inpatient days are calculated by subtracting day of admission from day of discharge | upto 10 Days |
| DAYS OF RETURN OF BOWEL FUNCTION. | It is defined as time to passage of flatus or stools after abdominal surgery. | Upto 24 hours |
| Pain score by Visual Analog Scale | Pain is defined as "an unpleasant sensory and emotional experience that is associated with actual or potential tissue damage or described in such terms" according to International Association for the Study of Pain,measured by Visual Analog Scale(VAS). | upto 36 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Bleeding peptic ulcer | Frequency of bleeding peptic ulcer | intraoperative period |
| Mortality rate | Estimation of mortality rate associated with perforated duodenal ulcer |
| Measure | Description | Time Frame |
|---|---|---|
| Gender distribution | To assess the frequency of perforated duodenal ulcer according to gender | Perioperative period |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Surgical Unit I,Benazir Bhutto Hospital | Rawalpindi | Punjab Province | 46000 | Pakistan |
Data can be shared on request.Only that described in the text of full article.
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP_ICF | Yes | Yes | Yes | Study Protocol, Statistical Analysis Plan, and Informed Consent Form | Aug 10, 2018 | Jun 10, 2020 | Prot_SAP_ICF_000.pdf |
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This randomized controlled trial was conducted in Surgical Unit 1 BBH from August 2018 to December 2019 with a total sample size of 36 patients with the diagnosis of perforated duodenal ulcer. Patients were randomly divided in two groups. Group A consisted of early oral feeding group and group B consisted of traditional postoperative care group. Outcome results studied were the length of hospital stay, duodenal repair site leak, severity of pain (VAS score) and duration of post-operative ileus. Results were analysed on SPSS version 20 and chi-square and independent t-test were applied.
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Patients admitted in the emergency department were randomly assigned into treatment group or control group in postoperative period.Neither the researcher nor the patient were aware of the patient allocation.Patients were management by the oncall surgical team irrespective of the researcher.
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| immediate postoperative period |