Retrospective Study Of Enhanced Recovery After Surgery Program For Patients Undergoing Colorectal Surgery, Which Included Fluid Therapy Tailored to Masimo's PVI, Showed Reduced Length Of Stay and Cost Savings

Masimo

announced today the results of a retrospective study of an Enhanced Recovery After Surgery (ERAS) program in colorectal surgery patients, which included Masimo's PVI® monitoring.(1) The ERAS program, which included fluid therapy tailored to PVI, resulted in reduced length of hospital stay, significantly reduced hospital costs, lower fluid administration, lower morphine administration, and earlier return of bowl function. The study was presented at the American Society of Anesthesiologists (ASA) Annual Meeting in New Orleans, the largest gathering of anesthesiologists in the world. In the retrospective study of the ERAS program implemented at the University of Virginia, Dr. Robert H. Thiele and colleagues compared the results of 108 patients managed with the ERAS program to 98 consecutive patients before the ERAS program was implemented. The ERAS program included goal-directed therapy with PVI, ingestion of a carbohydrate drink two hours prior to surgery, pre-operative multimodal analgesic regimen, intraoperative low-dose spinal morphine, limiting intraoperative opiates, intraoperative infusions of ketamine and lidocaine (continued 48 hours post-operatively), early mobilization, and oral intake post-operatively. Patients whose care was guided by the ERAS program with PVI had less fluid administered (973 ml vs 3,000 ml, p < 0.001), lower morphine equivalents (0.1 vs. 20, p < 0.001), earlier return of bowel function (p < 0.03), lower pain score (2.33 vs. 4.85, p < 0.001), fewer days of hospitalization (3 vs 5 days, P < 0.001), and lower hospital costs ($18,017 vs $15,150, P < 0.01). The investigators concluded: "While this program includes several measures, most significantly patients received markedly less fluid and opiates in the operating room. Our program is novel in the use of PVI to guide therapy. This work highlights the importance of selection of anesthesia technique in determining outcomes for patients. Our ongoing work is in applying the lessons learned from this program to patients undergoing other types of surgery." (1) Colquhoun D, Turrentine F, Rea K, Friel C, Hedrick T, Thiele R. Implementing a Health System Wide Enhanced Recovery Program for Patients Undergoing Colorectal Surgery - The Anesthesiologists Perspective. Proceedings of the American Society of Anesthesiologists, Oct.12, 2014, New Orleans, A2010, Room 245