Anesthesia and pain management in ERAS for spine surgery

Enhanced Recovery After Surgery (ERAS) is a multidisciplinary, evidence-based approach that has demonstrated significant benefits in spinal surgery, including reduced complications, shorter hospital stays, and improved patient satisfaction. Originally developed for colorectal and cardiothoracic procedures, ERAS protocols are increasingly applied to spine surgery, emphasizing preoperative optimization, multimodal analgesia, regional anesthesia, and intraoperative strategies such as minimally invasive techniques, blood conservation, and neuromonitoring. Postoperatively, early mobilization, nutritional support, and opioid-sparing pain management are critical to enhancing recovery. Successful ERAS implementation depends on multidisciplinary collaboration, standardized pathways, and ongoing quality improvement to overcome logistical barriers. Future directions include tailoring protocols for high-risk populations and leveraging patient-reported outcomes to refine care. As ERAS continues to evolve, it holds the potential to continue to transform perioperative spine care by integrating technology, evidence-based practices, and individualized patient management strategies.