Implementing Enhanced Recovery After Surgery (ERAS) Protocols in Resource-Limited Environments: A Critical Review for Nigerian Surgical Patients

Vollständiger Abstract

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Background: Enhanced Recovery After Surgery (ERAS) protocols have been shown to improve perioperative outcomes and reduce healthcare costs in various settings. However, their implementation in resource-limited environments, such as Nigeria, remains constrained due to infrastructural, economic, and sociocultural barriers. Methods: This critical review synthesizes current literature on the application of ERAS protocols in resource-constrained environments, with a focus on Nigeria. A comprehensive search of PubMed, Scopus, and African Journals Online was conducted to identify relevant studies. Data were extracted regarding the clinical benefits, cost-effectiveness, challenges, and context-specific strategies for ERAS implementation. Results: Evidence indicates that ERAS protocols can significantly reduce postoperative complications, length of hospital stay, and overall healthcare expenditure in resource-limited settings. Successful implementation requires adaptation of ERAS components to local realities, prioritization of low-cost and high-impact interventions, and active engagement of multidisciplinary stakeholders. Conclusion: The adoption of ERAS protocols in Nigeria requires careful adaptation to address local challenges and cultural factors. By focusing on readily available, reproducible, cost-effective strategies and fostering collaboration among healthcare providers, ERAS protocols can enhance surgical outcomes and optimize resource utilization in low- and middle-income countries. Keywords: Enhanced Recovery After Surgery (ERAS), perioperative care, resource-limited settings, Nigeria, surgical outcomes, healthcare optimization