Knowledge, Attitudes, and Practices of Orthopedic Surgical Healthcare Professionals Regarding Perioperative Anesthetic Management Under the Enhanced Recovery After Surgery (ERAS) Concept.

Abstract

Objective: Enhanced recovery after surgery (ERAS) has been popularized in clinical settings, and perioperative anesthetic management under the ERAS concept in orthopedic surgery is increasingly emphasized. This study aimed to assess the knowledge, attitudes, and practices (KAP) of orthopedic surgical healthcare professionals regarding perioperative anesthetic management.

Methods: This cross-sectional study included orthopedic surgical healthcare professionals at four hospitals between January and December 2023. A self-administered questionnaire was developed to collect participants' socio-demographic information and KAP scores. Structural equation modeling (SEM) was applied to assess direct and indirect associations among KAP dimensions.

Results: Totally, 386 participants were included, with a mean age of 36.17±8.34 years. The KAP scores were 23.23±5.88 (possible range: 0-30), 46.99±4.38 (possible range: 11-55), and 33.13±7.46 (possible range: 9-45), respectively. Multivariate logistic analysis revealed that age, employment in the anesthesiology department, ERAS training experience within the past year, and number of orthopedic surgeries in the past year were independently associated with good knowledge. Knowledge score, master's degree or above, and work experience were independently associated with a positive attitude. Knowledge score, attitude score, and employment in the anesthesiology department were independently associated with proactive practice. SEM further indicated positive associations between knowledge and attitude (β=0.29, P<0.001), between knowledge and practice (β=0.54, P<0.001), and between attitude and practice (β=0.30, P<0.001).

Conclusion: Orthopedic surgical healthcare professionals showed a positive attitude, while their knowledge and practice of perioperative anesthetic management remained at a moderate level. Educational and behavioral interventions are recommended for those with young age, shorter work experience, less surgical caseload, and lower educational levels.