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ASA: Same-Day Hip, Knee Replacement Feasible for Selected Patients

Last Updated: November 01, 2022.

TUESDAY, Nov. 1, 2022 (HealthDay News) -- Despite the pandemic and same-day admission limitations, effective multidisciplinary collaborations within Enhanced Recovery After Surgery (ERAS) pathways can improve services and provide continuity of care for total joint replacements, according to a study presented at the annual meeting of the American Society of Anesthesiologists, held from Oct. 22 to 25 in New Orleans.

Sunitha Singh, M.D., from Stony Brook Medicine in New York, and colleagues reported adaptions made to the current pathway such as developing a highly selective screening process to identify qualified candidates for ambulatory surgery; scheduling surgery before 10 a.m.; changing spinal anesthesia from an intermediate-acting to a shorter-acting agent; amending the postoperative urinary retention protocols; developing protocols for physical therapy to assess and mobilize patients in the recovery area prior to home discharge; discharging total knee replacement patients with a non-narcotic elastomeric (Q) pump; and arranging for postoperative home visits by a nurse and a physical therapist.

The researchers reported that during a 12-month period, 152 patients successfully completed this pathway. This pandemic population had an average length of stay of eight hours versus 1.7 days for patients on the traditional ERAS pathway. There were no readmissions reported during the study period. Preliminary data show an improvement in the utilization of resources and patient satisfaction.

"Education, prehabilitation, and patient engagement are critical to the recovery process," Singh said in a statement. "Patients often feel more rested recovering at home in familiar surroundings, and we have made the ERAS changes permanent due to the high success."

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