Abstract:

Objective To explore the application effect of enhanced recovery after surgery (ERAS) in perioperative nursing for spinal tuberculosis. Methods A prospective observational study was conducted in consecutive 159 spinal tuberculosis patients hospitalized in the Department of orthopedics, Beijing Chest Hospital from February 2020 to January 2021, all the patients were alternatively divided into observation group (n=79, treated with ERAS in perioperative nursing) and control group (n=80, treated with standard nursing in perioperative period). The first time of taking food, anal exhaust, defecation, getting out of bed and self-urination, the rate of catheter re-insertion, the incidence of complications, and the scores of numerical rating scale (NRS) were compared between the two groups. Results The first time of taking food, self-urination, anal exhaust, defecation, getting out of bed in the observation group were significantly earlier than those in the control group (12 (7,15) h vs. 47 (42, 52) h, Z=10.899, P<0.01; 5 (3, 6) h vs. 7 (5, 7) h, Z=5.307, P<0.01; (18.47±5.78) h vs. (45.54±7.94) h, t=24.600, P<0.01; (54.41±3.89) h vs. (65.37±5.96) h, t=13.748, P<0.01; (11.35±4.23) d vs. (14.57±5.63) d, t=8.364, P<0.01, respectively). The rate of re-insertion of urinary catheter and the incidence of complications in the observation group were both significantly lower than those in the control group (3.8% (3/79) vs. 15.0% (12/80), χ²=5.838, P=0.016; 12.7% (10/79) vs. 36.3% (29/80), χ ²=11.951, P=0.001). The scores of NRS 24 hours before operation, 2 hours, 24 hours and 72 hours after operation were significantly lower than those in the control group ((3.72±0.67) vs. (5.41±1.09), t=11.794; (3.70±0.88) vs. (4.51±0.73), t=6.320; (4.10±0.89) vs. (5.76±0.83), t=12.165; (3.32±0.84) vs. (4.24±0.73), t=7.374, respectively; all P<0.01). Conclusion The application of ERAS in perioperative nursing for spinal tuberculosis could promote the early recovery of patients after operation, reduce the postoperative complications and relieve the pain.

Key words: Tuberculosis, spinal, Perioperative care, Rehabilitation, Comparative effectiveness research