PD1075 - ADHERENCE TO ERAS NUTRITION PRACTICES IN GYNECOLOGICAL SURGERY: A CLINICAL AUDIT

PD1075

ADHERENCE TO ERAS NUTRITION PRACTICES IN GYNECOLOGICAL SURGERY: A CLINICAL AUDIT

K. Senanayake^1,*, S. Naleethan²

¹Clinical Nutrition, ²Obstetrics and Gynaecology, Post Graduate Institute of Medicine, Colombo , Sri Lanka

Rationale: Nutrition is a key component of Enhanced Recovery After Surgery (ERAS) pathways and contributes to improved perioperative outcomes. This audit evaluated adherence to nutrition-related ERAS practices in gynecological surgery.

Methods: A retrospective clinical audit was conducted among 40 consecutive patients who underwent major gynecological surgery at De Soysa Maternity Hospital, Sri Lanka from April to June 2025. Data were extracted from clinical records and compared with predefined audit standards based on ERAS nutrition recommendations. Assessed parameters included body mass index (BMI), preoperative nutritional assessment and counselling, carbohydrate loading, fasting practices, history of postoperative nausea and vomiting (PONV) or motion sickness, PONV prophylaxis, planned opioid use, and timing of postoperative oral intake. Descriptive statistics were used.

Results: Of 40 patients, 5% were underweight, 42.5% had normal BMI, 32.5% were overweight, and 20% were obese. None had documented preoperative nutritional assessment, counselling, or carbohydrate loading. All patients adhered to ERAS fasting recommendations and commenced oral intake within 24 hours postoperatively. A history of PONV or motion sickness was documented in 27.5%, but risk stratification was not performed in any patient. Nevertheless, 87.5% received PONV prophylaxis, and postoperative opioid use was planned for all. Five out of nine ERAS nutrition related practices met the predefined standards.

Conclusion: Adherence to ERAS recommendations for fasting, early postoperative feeding, and PONV prophylaxis was good. However, major gaps were identified in preoperative nutritional optimization, carbohydrate loading, and risk based PONV prevention. Local protocols and multidisciplinary implementation strategies are needed to improve ERAS nutrition practice.

Disclosure of Interest: None declared