ERAS survey in a low resources country

Abstract text (incl. references and figure legends)

AIM. Studying the real situation of enhanced recovery after surgery(ERAS) measures in a low resources country in emergency surgery. Matherial and methods. We presented a survey in Bolivia about ERAS in emergency surgery promoted by spanish group of multimodal rehabilitation (GERM). Survey was divided in 3 parts: personal view of ERAS in emergency surgery, general aspects, everyday measures in acute appendicitis, acute cholecystitis and acute diverticula. Results. 60 surgeons from Bolivia contributed to the survey. 49.21 of them were 50 years old or more. 98.41% believed that ERAS measures in emergency surgery were good for patients but only 65.08% of them applied ERAS measures in emergency surgery in their hospitals. Only in 33.33 % of their hospitals an ERAS program in elective surgery was presented. In 32.26 %, an emergency surgery unit was. The heat body control was important for 78.2% applying measures to mantain body temperatura as in elective surgeries. Acute apendicitis: The first dose of antibiotic must be during the first hour of diagnosis for 38.30 % and 59.57% thought that after a first dosis, it wasn´t necessary an extra-dosis independent of time after first dose. In its diagnosis, 76.09% used Scores. Laparoscopic approach is the best option for86.96% but only in 34.04% was laparoscopic approach the mandatory approach. When they found purulent fluid , 82.98 % aspirated and cleaned the fluid. Control pain was performed by local anesthesia in trocar placements in 44.91%. Acute Cholecystitis: 53.19% recommended antibiotic treatment during a week. Only 39.53 put local anesthesia in trocar placements although 53.49% of them considered that that measure was good for pain control. Acute diverticula: CT is the best option for 80.85% although 53.19% beleived that ultrasound is very useful. Conclusions. ERAS programs would be a succes option after a positive attitude in Bolivian surgeons

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