An enhanced recovery program improves the comfort and outcomes in children with obstructive sleep apnea undergoing adenotonsillectomy：A retrospective historical control study.

Objective To explore the effects of an enhanced recovery after surgery (ERAS) program on postoperative rehabilitation in children with obstructive sleep apnea (OSA) during the perioperative period of adenotonsillectomy. Design A retrospective historical control study SETTING: Service improvement project PARTICIPANTS: The study included 394 children with OSA (207 males, 187 females; age range, 2.5 y to 14 y) who underwent adenotonsillectomy. Main outcome measures The children who had undergone adenoidal ablation and bilateral tonsillectomy were divided into an ERAS group (208 patients) treated with the combined optimization measures and a control group (186 patients) that was treated with traditional measures during the perioperative period. The postoperative incidence of complications, pain scores, anxiety scores, and postoperative diets in the two groups were assessed. Results Patients in the ERAS group had significantly a lower overall complication rate and incidence of fever for 2 weeks of follow-up when compared to patients in the control group through the application of perioperative optimization measures. Furthermore, patients in the ERAS group had less post-surgical pain, better dietary intake at day 1, 3 and 7 after surgery, and had lower pre-operative anxiety scores after admission education and while waiting in the operation room. Conclusion The ERAS program consisting of combined optimization measures can reduce physical and psychological trauma during the perioperative period of adenotonsillectomy performed for children with OSA.