Pain Management Strategies Following Enhanced Recovery After Surgery (ERAS) Protocols in Patients Undergoing Gastric Cancer Surgery: A Systematic Review
Volume 1, Issue 4, April 2025, Pages 126-129
https://doi.org/10.22034/mphrj.2025.530958.1016
Giti Dehghan Manshadi
Abstract Introduction: Effective postoperative pain management is essential for enhanced recovery in gastric cancer surgery. Enhanced Recovery After Surgery (ERAS) protocols emphasize multimodal, opioid-sparing strategies to improve outcomes, but their impact specifically in gastric cancer patients remains underexplored.
Methods: A systematic review was conducted to evaluate pain management methods integrated within ERAS protocols for patients undergoing gastric cancer surgery. Databases including PubMed, Scopus, and Web of Science were searched for studies published between 2018 and 2024. Inclusion criteria were adult patients undergoing elective gastric cancer surgery with reported postoperative pain outcomes under ERAS protocols. Data on study characteristics, analgesic methods, pain scores, opioid consumption, and recovery outcomes were extracted and analyzed.
Results: Five studies met inclusion criteria, encompassing 529 patients. Regional analgesia (e.g., epidural, TAP block) combined with non-opioid systemic medications significantly reduced 24-hour postoperative pain scores (VAS range: 2.86–4.14) and opioid consumption (15.33–21.78 mg morphine equivalents). ERAS-compliant groups also showed faster ambulation, earlier return of bowel function, shorter hospital stays, and lower complication and readmission rates.
Conclusion: Incorporating multimodal, regional pain management within ERAS protocols improves pain control and accelerates recovery in gastric cancer surgery. Standardized implementation can enhance postoperative outcomes and reduce opioid use.