Doctors are using new strategies to help children bounce back quicker after major surgery. These strategies, called ERAS protocols, focus on preparing kids before surgery, managing pain without heavy drugs during surgery, and getting them moving and eating normally right after. Research shows that when hospitals follow these organized plans, kids spend less time in the hospital, need fewer strong pain medications, and get back to their normal activities faster. This review looks at how these proven methods work specifically for children, whose bodies handle surgery stress differently than adults.

The Quick Take

  • What they studied: How doctors can help children recover better and faster after major surgery by using organized care plans that cover everything from before surgery through going home
  • Who participated: This is a review article that looked at research and expert opinions about children having major surgery. It didn’t study one specific group of kids, but instead gathered information from many different studies and medical experts
  • Key finding: When hospitals use these organized recovery plans for kids, children go home sooner, need fewer strong pain medicines, and get back to eating and moving around faster than with traditional care
  • What it means for you: If your child needs major surgery, asking your hospital if they use these recovery protocols may help your child feel better faster and spend less time in the hospital. However, the best approach depends on your child’s specific situation and what your doctors recommend

The Research Details

This is a review article, which means doctors and researchers looked at all the current scientific studies and expert opinions about helping children recover from surgery. Instead of doing one new experiment, they gathered information from many different hospitals and research studies to see what works best.

The researchers focused on three time periods: before surgery (preparing the child), during surgery (what doctors do in the operating room), and after surgery (helping the child get better at home). They looked at what hospitals are doing differently now compared to the old ways, and what benefits kids are seeing from these new approaches.

This type of study is helpful because it brings together lots of different research to show the bigger picture of what works, rather than just looking at one hospital or one group of kids.

Understanding how to help children recover better from surgery is really important because kids aren’t just small adultsā€”their bodies handle surgery stress differently. By looking at all the research together, doctors can figure out the best practices that work specifically for children. This helps hospitals create better plans that reduce pain, complications, and time spent away from home and school.

This is a review of existing research and expert opinions, so it’s based on what other scientists have already discovered. The strength of the findings depends on the quality of those original studies. The authors looked at current literature and expert consensus, which means they tried to include the best available information. However, because this is a review rather than a new experiment, it shows what research suggests rather than proving something new. More research is still being done in this area, especially for children.

What the Results Show

The research shows that when hospitals use organized ERAS recovery plans for children, several good things happen. Kids spend less time in the hospitalā€”sometimes going home days earlier than with traditional care. This means less time away from family, friends, and school.

Children also need fewer strong pain medicines, especially opioids (powerful drugs that can have side effects). Instead, doctors use other ways to control pain, like numbing medicines given near the surgical area or other non-opioid pain relievers. This helps kids feel better without the risks that come with heavy pain medications.

Another big benefit is that kids get back to eating normal food faster. Instead of waiting days to eat, children on these recovery plans can often start eating sooner, which helps their bodies heal. Kids also start moving around and doing light activities sooner, which helps prevent complications and speeds up recovery.

Overall, these organized plans help reduce problems after surgery and get kids back to their normal lives faster.

The research also found that these recovery plans help reduce the amount of fluids doctors give during surgery. Doctors now use smarter ways to figure out exactly how much fluid each child needs, rather than giving too much or too little. This helps prevent swelling and other complications.

Hospitals that use these plans also report better satisfaction from parents and children because kids recover faster and have fewer problems. The organized approach means everyone on the medical teamā€”surgeons, anesthesiologists, nurses, and othersā€”is working together with the same goals, which improves the whole experience.

These recovery protocols started with adult surgery and have been adapted for children. The research shows that while the basic ideas work for kids too, doctors have had to adjust them because children’s bodies are different. Previous approaches often kept kids in the hospital longer, used more pain medications, and delayed getting back to normal activities. The new ERAS approach is more active and organized, focusing on getting kids moving and eating sooner. Studies suggest this newer approach works better for children than the old way of just waiting for kids to recover on their own.

This is a review article, so it’s based on other studies rather than new research. Some of the studies it reviews might be small or done in different ways, which can make it harder to compare results. The research is still emerging, meaning doctors are still learning the best ways to use these protocols for different types of surgery and different ages of children. Not all hospitals have adopted these plans yet, so real-world results may vary. More research is needed to understand which parts of the protocol work best for which children and types of surgery.

The Bottom Line

If your child needs major surgery, it’s worth asking your hospital if they use ERAS recovery protocols. The evidence suggests these organized plans help children recover faster with fewer complications and less pain medication. However, the best approach depends on your child’s age, health, and the type of surgery. Work with your surgical team to understand what’s best for your specific situation. (Confidence level: Moderateā€”research is promising but still developing)

Parents and families of children needing major surgery should care about this. Children of all ages undergoing significant surgery may benefit. However, the specific protocols may need to be adjusted for very young children or children with certain health conditions. Talk to your child’s doctors about whether these approaches are right for your situation. These findings are less relevant for minor procedures or emergency surgeries where there’s no time to prepare.

Benefits typically appear quicklyā€”children often go home several days earlier than with traditional care. Pain control improvements and return to normal eating usually happen within days to a week after surgery. Getting back to full normal activities may take a few weeks, depending on the type of surgery. Most children notice they feel better and stronger within the first 1-2 weeks after surgery when these protocols are used.

Want to Apply This Research?

  • Track your child’s pain level daily (using a simple 1-10 scale or pain faces chart), note when they start eating solid foods, record when they first get out of bed and move around, and mark the date they go home from the hospital. Compare these milestones to what doctors predicted.
  • Before surgery: Work with your medical team to understand the recovery plan and prepare your child mentally. After surgery: Follow the hospital’s guidance on early movement and eatingā€”even small walks and sips of water help recovery. At home: Keep a simple log of pain levels, food intake, and activity to share with your doctor at follow-up visits.
  • Use the app to set reminders for pain medication times, track when your child can do more activities (walking further, playing more), and monitor return to normal eating. Share this information with your child’s doctor at follow-up appointments to ensure recovery is on track and adjust the plan if needed.

This article reviews research about recovery protocols for children having major surgery. It is for educational purposes only and should not replace advice from your child’s doctors. Every child is different, and the best approach to surgery and recovery depends on your child’s specific health situation, age, and type of surgery. Always discuss surgical preparation and recovery plans with your child’s surgical team and anesthesiologist. If you have concerns about your child’s recovery after surgery, contact your healthcare provider immediately. This information is current as of the publication date but medical practices continue to evolve.