Efficacy of Enhanced Recovery after Surgery (ERAS) protocol in maxillofacial trauma: A randomized controlled trial.

INTRODUCTION: Enhanced Recovery after surgery (ERAS) guidelines have been formulated in the literature for various different specialties but none is present for maxillofacial trauma patients. Hence, we have formulated ERAS protocol for maxillofacial trauma (ERAS-MT) patients and compared with the patients receiving the standard traditional care for post trauma outcomes. METHODOLOGY: A randomized controlled trial included 74 patients divided into two groups: Group 1 (ERAS group:37 patients) and Group II (Control group:37 patients). ERAS group were intervened according to the formulated ERAS protocol based on the previous literature and the control group received the standard of care. The both groups were compared for various post trauma outcomes. RESULTS: Baseline demographic data was non-significant between both the groups. There was significant decrease in pre-operative IV fluid use and total number of IV analgesics used till 72 h as well as in the immediate post operative period in the ERAS group(p = 0.001). ERAS group started oral feeds within 6 h and they were significantly compliant for oral carbohydrates in the pre-operative phase(p = 0.001). PONV episodes, swelling and infections were insignificantly less in the ERAS group(p > 0.05), however a significant difference was seen throat pain and decreased anxiety as well as Oral Hygiene Index(p = 0.001). At two weeks, a significant difference was seen in overall patient's satisfaction and cost analysis in the ERAS group (p = 0.001). CONCLUSION: Our study suggested that ERAS protocol was associated with shorter hospital stay, early recovery with better overall satisfaction of the patients, lesser post-operative complications and significantly decreased cost analysis.

Factors Related to Positive Memory Count Among Trauma-Exposed Individuals: A Scoping Review.

To examine the existing knowledge base on trauma experiences and positive memories, we conducted a scoping review of trauma and post-trauma factors related to positive memory count. In July 2019, we searched PubMed, Medline, PsycINFO, Web of Science, Cumulative Index of Nursing and Allied Health Literature, Embase, and PTSDpubs for a combination of words related to "positive memories/experiences," "trauma/posttraumatic stress disorder (PTSD)," and "number/retrieval." Twenty-one articles met inclusion criteria (adult samples, original articles in English, peer-reviewed, included trauma-exposed group or variable of trauma exposure, trauma exposure examined with a trauma measure/methodology, assessed positive memory count, empirical experimental/non-experimental study designs). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, two authors reviewed abstracts, completed a secondary search, and independently extracted data. Our review indicated (1) that depression and PTSD were most researched; (2) no conclusive relationships of positive memory count with several psychopathology (depression, acute stress disorder, eating disorder, and anxiety), cognitive/affective, neurobiological, and demographic factors; (3) trends of potential relationships of positive memory count with PTSD and childhood interpersonal traumas (e.g., sexual and physical abuse); and (4) lower positive memory specificity as a potential counterpart to greater overgeneral positive memory bias. Given variations in sample characteristics and methodology as well as the limited longitudinal research, conclusions are tentative and worthy of further investigations.