Enhanced recovery after surgery: overarching themes of the ERAS® Society Guidelines & Consensus Statements for Adult Specialty Surgery

BACKGROUND: The Enhanced Recovery After Surgery (ERAS®) Society has overseen the development and publication of more than two dozen specialty-specific guidelines and consensus statements. We conducted an appraisal of existing guidelines to compare and contrast recommendations to identify overarching themes regarding the current role and future direction of those guidelines for clinicians and researchers. METHODS: After deriving a list of potential perioperative interventions associated with an ERAS program, specialty-specific guidelines were evaluated on the basis of their inclusion and the strength of the grade of those elements. RESULTS: Following appraisal of the existing ERAS guidelines, a list of common interventions emerges, which includes pre-, intra-, and postoperative care elements that are endorsed by the overwhelming majority of surgical specialties. However, this perioperative rubric should be modifiable to include a broader range of potential perioperative elements, where appropriate, based on literature specific to those subspecialty surgeries. CONCLUSIONS: More uniform consensus regarding common care elements is likely to contribute to greater harmony in guidelines development as well as the development of process measures and outcome definitions. Guidelines can thus foster the creation of data repositories, establish program benchmarks, and contribute to future research and knowledge transfer.