Decreased hospital charges and postoperative pain in septoplasty by application of enhanced recovery after surgery

Figures & data

Table 1 Patient characteristics

	ERAS group (n=25)	Control group (n=25)
Age, mean±SD, (years)	37.2±10.5	35.6±13.7
Sex (female:male)	15:10	13:12
BMI, mean±SD, (kg/m^2)	21.1±2.9	22.7±2.0

Abbreviations: BMI, body mass index; ERAS, enhanced recovery after surgery.

Table 2 Concrete implementation measures of ERAS

	ERAS group	Control group
Preoperative
ERAS educationa	Done	None
Nothing Per osb	Fasting 6 hours, fasting water 2 hours	8 hours
Intraoperative
Anesthesia scheme	Local anesthesia and GA	Tracheal intubationa and GAc
Temperature control	Supervise and avoid hypothermia	Common processing
Liquid control	Recude the infusion	Common processing
Cavity processing	Nasal septum stitching, without nasal filling	Expansion sponge
Postoperative
Common analgesia	Oral NSAID	None
Early eating and drinking	2 hours after surgery	None
Early off-bed activity	2 hours after surgery	None
Remove nasal pecking	None	48 hours after surgery

Notes:

a ERAS education: explaining of ERAS process and signing of informed notification.

b Nothing Per os: fasting for solids and liquids.

c GA: common processing.

Abbreviations: ERAS, enhanced recovery after surgery; GA, general anesthesia; NSAID, nonteroidal anti-inflammatory drug.

Figure 1 The mean hospital stay of patients in the ERAS group was shorter than the control group.

Abbreviation: ERAS, enhanced recovery after surgery.

Figure 2 The mean total cost in ERAS group was lower than the control group.

Abbreviation: ERAS, enhanced recovery after surgery.

Table 3 Analysis of control group and ERAS group

	ERAS group	Control group	P-value
Length of stay, mean±SD, (days)	4.4±0.5	5.8±0.8	<0.001
Operating time, mean±SD, (minutes)	33.4±4.1	30.7±5.1	0.103
Bleeding volume, mean±SD, (mL)	6.2±2.1	6.6±2.3	0.161
Total cost, mean±SD, (Dollars)	1,252.5±21.0	1,333.7±38.1	<0.001
Complications	0	0	–

Notes: Statistically significant (P<0.05); – indicates that not able to compare P values between the two groups.

Abbreviation: ERAS, enhanced recovery after surgery.

Figure 3 The SAS score in ERAS group was lower than the control group in preoperation and 3 days postoperation, but showed no significant difference compared with those of 7 days postoperation.

Abbreviations: ERAS, enhanced recovery after surgery; SAS, Self-Rating Anxiety Scale.

Table 4 SAS score preoperation and after operation

SAS score	ERAS group	Control group	P-value
Preoperation	35.4±6.2	43.6±8.6	<0.001
3 days	31.6±5.4	38.1±10.4	0.034
7 days	29.2±5.0	31.2±9.3	0.305

Notes: Statistically significant (P<0.05). Data presented as mean±SD.

Abbreviation: SAS, Self-Rating Anxiety Scale.

Figure 4 The VAS of nasal obstruction in ERAS group was lower than the control group.

Abbreviations: ERAS, enhanced recovery after surgery; VAS, visual analog symptom score.

Figure 5 The VAS of sleep disturbance in ERAS group was lower than the control group.

Abbreviations: ERAS, enhanced recovery after surgery; VAS, visual analog symptom score.

Table 5 VAS score preoperation and after operation

VAS	Preoperation	1 day	2 days	3 days	4 days	5 days
Nasal obstruction
ERAS group	7.2±1.5	5.1±1.2*	3.5±1.2*	2.8±0.9*
Control group	6.9±1.5	9.2±0.7	9.0±0.8	5.5±1.7	4.1±1.2	3.0±1.1
Sleep disturbance
ERAS group	1.6±1.2	3.1±1.4*	2.6±1.3*
Control group	1.9±1.5	6.7±2.4	6.5±2.3	4.3±1.0	2.8±1.1
Head facial pain
ERAS group	0	3.5±1.3*	2.4±0.9*	2.0±0.8*
Control group	0	6.5±2.2	6.0±2.0	3.9±0.9	3.1±0.9	2.5±0.6

Notes: Data presented as mean±SD.

* Statistical differences between ERAS group and Control group (P<0.05).

Abbreviations: ERAS, enhanced recovery after surgery; VAS, visual analog symptom score.

Figure 6 The VAS of head facial pain in ERAS group was lower than the control group.

Abbreviations: ERAS, enhanced recovery after surgery; VAS, visual analog symptom score.