Adapting enhanced recovery after surgery protocols for day-care surgeries under general anesthesia at a tertiary care ophthalmic setting.

Abstract

Objective: To evaluate the feasibility and benefits of implementing Enhanced Recovery After Surgery (ERAS) protocols in elective ophthalmic day-care surgeries conducted under general anesthesia at the tertiary care ophthalmic center.

Methods: This prospective observational study included 70 patients aged above 1 month undergoing elective ophthalmic surgery under general anesthesia. Key ERAS elements were adapted, including structured preoperative counselling, optimized fasting, multimodal analgesia, prophylaxis for postoperative nausea and vomiting (PONV), early oral intake, and use of the Aldrete score for discharge readiness. Pain was assessed using age-appropriate scoring systems like Visual Analogue Scale (VAS), Face, Legs, Activity, Cry, Consolability (FLACC) and patient feedback was obtained using a validated questionnaire. Data were analyzed using SPSS.

Results: Mean fasting durations were 7.04 ± 1.2 hours for solids and 3.02 ± 1.22 hours for clear liquids. A low-dose opioid regimen combined with paracetamol ensured effective pain control; only a small number of patients required rescue analgesia. The overall incidence of PONV was low (8.6%), and early oral fluid intake was well tolerated. Most participants reported high satisfaction with their perioperative experience, with 91.4% scoring 4 or 5 on a 5-point scale. No adverse events or delayed discharges were observed.

Conclusion: Integrating ERAS principles into ophthalmic day-care anesthesia is feasible and associated with improved recovery, reduced discomfort, and high patient satisfaction. A structured, multidisciplinary approach tailored to the ambulatory context can enhance perioperative care without compromising safety.