Anestéziológia a intenzívna medicína 1/2024

ERAS guidelines for total hip and total knee replacement, recommendations and practice

Since its inception, ERAS study group and ERAS society have published numerous unified EBM protocols for various types of surgical procedures in various surgical disciplines. Orthopedic operations, especially large joint replacements, are also suitable candidates for the application of ERAS procedures. However, despite efforts, a unified protocol for total hip and total knee replacement surgery has not been created yet. We have at our disposal “only” recommendations/guidelines with different strength and level of evidence of their ability to reduce perioperative stress, minimize complications and shorten hospitalization time. By strictly following these recommendations, we can shorten the time of hospitalization for total hip and total knee replacement from the original 4-7 days to 1-3. In the environment of our hospital, we are relatively successful in following the mentioned recommendations, even if we have to adjust them to varying degrees in the context of the reality of the habits of the staff of the Trauma surgery clinic, where the operations are taking place. I followed the postoperative course of 49 patients after the replacement of large joints of the lower limbs, I discuss the research results in more detail in my work.

Keywords: ERAS guidelines, EBM, total hip replacement, total knee replacement, postoperative course