Vol 2-2 Commentary

Commentary: Assessing the functionality of an emergency obstetric referral system and continuum of care among public healthcare facilities in a low resource setting: an application of process mapping approach

Bernice Ofosu1, Dan Ofori2, Michael Ntumy1,3, Kwaku Asah-Opoku1,3, Theodore Boafor1,3*

1Department of Obstetrics & Gynaecology, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana

2University of Ghana Business School, Legon, Ghana

3University of Ghana Medical School, Korle-Bu, Accra, Ghana

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Vol 2-2 Mini Review Article

A Mini-Review of Enhanced Recovery After Surgery (ERAS®) & Enhanced Recovery After Thoracic Surgery Protocols (ERATS)

Karishma Kodia*, Dao M. Nguyen

Section of Thoracic Surgery, Division of Cardiothoracic Surgery, University of Miami, Miami, Florida, USA

Enhanced recovery after surgery protocols (ERAS®) have become increasingly popular in the past few decades. Initially instituted by csolorectal and gynecologic surgery, these optimized "fast track" pathways have expanded across surgical sub-specialties. We discuss critical components of such pathways, the implementation process, and particular facets of perioperative care that apply to various surgical subspecialties including cardiac, colorectal, gynecologic, and thoracic surgery. The spirit of ERAS® emphasizes a continuous internal auditing process. ERAS® protocols are known for faster recovery, shorter length of stay, improved pain control, and optimization of a patient’s perioperative course by way of a standardized protocol. The unique aspects of enhanced recovery after thoracic surgery (ERATS) protocols are discussed. We focus on intercostal nerve blocks as an important component of ERATS pathways and optimized postoperative pain control. Intercostal nerve blocks in thoracic surgery allow for excellent postoperative pain control, which is critical for early ambulation, improved chest physiotherapy and easier progression through the post-operative course. This mini-review serves to highlight key features of ERAS®, salient aspects of niche surgical specialties, and focuses on thoracic surgery enhanced recovery protocols and intercostal nerve blocks in the context of ERATS for optimized postoperative pain control.

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