Implementing ERAS: How We Achieved Success Within an Anesthesia Department

Dan B. Ellis; Aalok Agarwala; Elena Cavallo; Pam Linov; Michael K. Hidrue; Marcela G. del Carmen; Rachel Sisodia


BMC Anesthesiol. 2021;21(36) 

In This Article


A total of 1059 surgeries were performed during the baseline period, 852 surgeries during the intervention period, and 659 during the post-intervention period. See Table 1 for patient demographics.

Compared to the baseline period, compliance with four of five ERAS metrics measured showed statistically significant improvement during the intervention period (Table 2). Compliance with use of preemptive analgesia increased from 42 to 85% (odds ratio (OR) = 8.3, 95%CI = 6.5–10.6). Compliance with intra-op fluid management increased by 58% (OR = 1.58, 95% CI = 1.25–1.99). Dosage of short-acting narcotics decreased by 14% (rate ratio (RR) = 0.86, 95% CI = 0.82–0.90), and dosage for long-acting narcotics decreased by 9% (RR = 0.91, 95%CI = 0.82–1.00).

Importantly, the improvements during the intervention period were sustained during the post-intervention period (see Table 3), as practitioners did not deviate in a statistically significant manner from practices that were established during the intervention period despite no active engagement from the administration. Compliance with use of antiemetics, which was already at 91.3% during the baseline period, did not show significant change on either the intervention or post intervention period.