enhanced recovery after surgery (eras) protocol for craniotomy patients: a systematic review

Context: the enhanced recovery after surgery (eras) protocol is a multidisciplinary approach aimed at improving surgical outcomes, reducing complications, minimizing hospital stays, and lowering healthcare costs.objectives: this study assesses the impact of the eras protocol on elective craniotomies, a routine procedure in neurosurgery. methods: a comprehensive search across pubmed, embase, scopus, and web of science identified 562 articles. following strict screening criteria, 54 studies were reviewed, and ultimately 10 studies meeting the inclusion criteria were selected for detailed analysis. results: the review encompassed ten studies [one prospective, one systematic review, and eight randomized controlled trials (rcts)] published between 2016 and 2023. key components of the eras protocol included preoperative counseling, high-protein intestinal nutrition, preoperative fasting while avoiding carbohydrate intake within 2 hours of surgery, standardized anesthetic and analgesic regimens, and early postoperative initiation of enteral feeding. postoperative outcomes showed fewer complications, early mobilization, and notably shorter hospital stays, all of which contributed to improved patient recovery. conclusions: this review demonstrates that the eras protocol, when applied to elective craniotomies, is effective in enhancing postoperative recovery, improving functional outcomes, and reducing hospitalization duration.