Role of Perianesthesia Nurses in Enhanced Recovery After Surgery (ERAS) Protocols: A Narrative Review and Comparative Outcomes Analysis

Abstract

Background: Enhanced Recovery After Surgery (ERAS) protocols are comprehensive, interdisciplinary frameworks aimed at minimizing surgical stress, standardizing perioperative care, and expediting recovery. Perianesthesia nurses, who operate in preoperative assessment units and post-anesthesia care units (PACU), play a vital role in ensuring the integrity of ERAS implementation.
Objectives: To compile and analyze current evidence regarding the impact of perianesthesia nursing care on surgical outcomes pre- and post-anesthesia, and to compare outcomes of ERAS with traditional care practices.
Methods: A narrative review of ERAS guidelines along with recent meta-analyses and clinical trials (2016–2025) focusing on nursing-sensitive processes (such as patient education, anxiety management, adherence to PONV prophylaxis, multimodal pain management, early mobilization, and readiness for discharge) as well as outcomes (including length of hospital stay, complications, readmission rates, and time to PACU discharge).
Results: Meta-analyses across different specialties indicate that the adoption of ERAS correlates with reduced hospital stays and a decrease in complications without an increase in readmission rates or mortality. Processes led by perianesthesia nurses—including the education of patients and setting their expectations, adherence to carbohydrate loading and fasting guidelines, maintenance of normothermia, PONV prophylaxis based on risk assessment, opioid-sparing pain management, protocols for the removal of urinary catheters/lines, and encouragement of early oral intake and ambulation—contribute to these positive outcomes. Research also reveals that ERAS programs facilitate quicker fulfillment of discharge criteria in the PACU.
Conclusion: Perianesthesia nurses implement ERAS protocols at the bedside, effectively converting these guidelines into dependable practices that enhance recovery milestones and diminish complications. Ongoing benefits are contingent upon systematic documentation, effective interprofessional communication, and continuous performance audit and feedback.