Impact of enhanced recovery after surgery on stress response in patients undergoing endoscopic sinus surgery
Objective To observe the impact of Enhanced Recovery After Surgery(ERAS)perioperative management on postoperative inflammation and stress response in patients undergoing functional endoscopic sinus surgery.Methods Fifty patients with chronic rhinosinusitis with nasal polyps(CRSwNP)admitted to a hospital in Chongqing from December 2020 to March 2022 were selected and randomly assigned to the ERAS group(ERAS 1 group)and the control group(C1 group),with 25 patients in each group.Fifty patients with chronic rhinosinusitis without nasal polyps(CRSsNP)admitted during the same period were randomly assigned to the control group(C2 group)and the ERAS group(ERAS 2 group),with 25 pa-tients in each group.The ERAS group received ERAS perioperative management,while the control group received conven-tional perioperative management.The Self-Rating Anxiety Scale(SAS)score,preoperative thirst and hunger score,postop-erative pain and sleep quality Visual Analog Scale(VAS)score,and changes in inflammation and stress indicators were compared among different groups.Results In terms of preoperative and postoperative SAS scores,the ERAS 1 group had significantly lower scores than the C1 group(P＜0.05),and the ERAS 2 group had significantly lower scores than the C2 group(P＜0.05).In terms of preoperative thirst and hunger scores,the ERAS 1 group had significantly lower scores than the C1 group(P＜0.05),and the ERAS 2 group had significantly lower scores than the C2 group(P＜0.05).In terms of postoperative pain VAS scores at 2 hours,6 hours,and 24 hours,the ERAS 1 group had significantly lower scores than the C1 group(P＜0.05),and the ERAS 2 group had significantly lower scores than the C2 group(P＜0.05).The differences in postoperative pain VAS scores at 48 hours and 72 hours were not statistically significant between the ERAS 1 group and the C1 group(P＞0.05),and no significant difference was found between the ERAS 2 group and the C2 group(P＞0.05).In terms of postoperative sleep quality VAS scores at 1 day and 2 days,the ERAS 1 group had significantly lower scores than the C1 group(P＜0.05),and the ERAS 2 group had significantly lower scores than the C2 group(P＜0.05).No sig-nificant difference in postoperative sleep quality VAS scores at 3 days was observed between the ERAS 1 group and the C1 group(P＞0.05)or between the ERAS 2 group and the C2 group(P＞0.05).In terms of preoperative white blood cell(WBC),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),cortisol(Cor),and adrenocorticotropic hormone(ACTH)levels,no significant difference was observed between the ERAS 1 group and the C1 group(P＞0.05)or between the ERAS 2 group and the C2 group(P＞0.05).In terms of postoperative WBC,CRP,TNF-α,Cor,and ACTH levels,the ERAS 1 group had significantly lower levels than the C1 group(P＜0.05),and the ERAS 2 group had significantly low-er levels than the C2 group(P＜0.05).Conclusion ERAS perioperative management can reduce perioperative anxiety in patients undergoing endoscopic sinus surgery,promote preoperative thirst and hunger,alleviate postoperative pain,raise postoperative sleep quality,and reduce postoperative inflammatory and stress responses.
Enhanced recovery after surgeryFunctional endoscopic sinus surgeryInflammationStressChronic rhinosi-nusitis
万方数据
维普
