Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Original Investigation

Compliance with Enhanced Recovery After Surgery (ERAS) protocol recommendations for bariatric surgery in an obesity treatment center

Conformidade com as recomendações do protocolo Enhanced Recovery After Surgery (ERAS) para cirurgia bariátrica em um centro de tratamento de obesidade

Júlia Gonçalves Zandomenico, Fabiana Schuelter Trevisol, Jean Abreu Machado

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The higher risk of perioperative complications associated with obesity has made anesthesiologists increasingly concerned with the management of obese patients. Measures that improve bariatric surgery patient safety have become essential. The implementation of ERAS protocols in several surgical specialties has made it possible to achieve appropriate outcomes as to surgery safety. The aim of this study was to evaluate patient compliance with the recommendations of an ERAS protocol for Bariatric Surgery (ERABS) at a hospital specialized in obesity treatment.

Cross-sectional study, using a medical record database, in a hospital certified as an International Center of Excellence in Bariatric and Metabolic Surgery. The definition of the variables to be assessed was based on the most recent ERABS proposed by Thorell et al. Results were analyzed using descriptive epidemiology.

The study evaluated all patients undergoing bariatric surgery in 2019. Mean compliance with the recommendations per participant was 42.8%, with a maximum of 55.5%, and was distributed as follows: 22.6% of compliance with preoperative recommendations, 60% to intraoperative recommendations, and 58.1% to postoperative recommendations. The anesthesiologist is the professional who provides most measures for the perioperative optimization of bariatric surgery patients. In our study we found that anesthesiologists complied with only 39.5% of ERABS recommendations.

Mean compliance with ERABS recommendations per participant was 42.8%. Considering that the study was carried out at a hospital certified as an international center of excellence, the need for introducing improvements in the care of patients to be submitted to bariatric surgery is evident.


Bariatric surgery Enhanced recovery after surgery Perioperative care



O maior risco de complicações perioperatórias associadas à obesidade tem tornado os anestesiologistas cada vez mais preocupados com o manejo de pacientes obesos. Medidas que melhorem a segurança do paciente em cirurgia bariátrica tornaram-se essenciais. A implantação de protocolos ERAS em diversas especialidades cirúrgicas tem possibilitado resultados adequados quanto à segurança cirúrgica. O objetivo deste estudo foi avaliar a adesão dos pacientes às recomendações de um protocolo ERAS para Cirurgia Bariátrica (ERABS) em um hospital especializado no tratamento da obesidade.


Estudo transversal, utilizando banco de dados de prontuários, em um hospital certificado como Centro Internacional de Excelência em Cirurgia Bariátrica e Metabólica. A definição das variáveis a serem avaliadas foi baseada no ERABS mais recente proposto por Thorell et al. Os resultados foram analisados por epidemiologia descritiva.


O estudo avaliou todos os pacientes submetidos à cirurgia bariátrica em 2019. A média de adesão às recomendações por participante foi de 42,8%, com máximo de 55,5%, e assim distribuída: 22,6% de adesão às recomendações pré-operatórias, 60% às recomendações intraoperatórias e 58,1% às recomendações pós-operatórias. O anestesiologista é o profissional que mais provê medidas para a otimização perioperatória dos pacientes de cirurgia bariátrica. Em nosso estudo, descobrimos que os anestesiologistas cumpriram apenas 39,5% das recomendações do ERABS.


O cumprimento médio das recomendações ERABS por participante foi de 42,8%. Considerando que o estudo foi realizado em um hospital certificado como centro

de excelência internacional, fica evidente a necessidade de introduzir melhorias no atendimento aos pacientes a serem submetidos à cirurgia bariátrica.


Cirurgia bariátrica; Recuperação melhorada após a cirurgia; cuidados perioperatórios


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