Enhanced Recovery. The Evolution of Pediatric Spinal Fusion Care.

The concept of enhanced recovery after surgery (ERAS) is almost 20 years old and up to this time it has largely been used as a multimodal perioperative care pathway in adult surgical patients to achieve early recovery after major surgery. ERAS is not a revolution in care as much as it is an acknowledgement that the 'old way' of recovering patients with high dose opioids, prolonged fasting states, excessive intravenous fluids, and prolonged bed rest were not ideal for patient well-being and delayed recovery. In fact, by implementing simple evidence-based interventions including sensible preoperative fasting strategies, anti-emetic prophylaxis and multimodal analgesia, patients have improved recoveries with fewer complications.