2.2.3. ERAS perioperative management.
diabetes, blood glucose, insomnia, anxiety, pain
HYPERTENSION, CAVITY, COLD, POSTOPERATIVE COMPLICATIONS
Prior to the operation, the attending physician, anesthesiologist, rehabilitation physician, and the nurse-in-charge communicated with each patient in detail. This team comprehensively assessed physiological, psychological, mental, and nutritional status, and informed the patient about measures specific to ERAS, postoperative complications, and the rehabilitation plan. Based on the patient’s condition, targeted health education was provided, and an individualized ERAS plan was formulated. Patients were provided psychological counseling to alleviate adverse emotions, such as tension and anxiety. For patients with hypertension, short-acting antihypertensive drugs were administered on the day of surgery to control blood pressure. For patients with diabetes, blood glucose was strictly controlled. Patients with insomnia were treated with oral zolpidem tartrate tablets. Patients were instructed to avoid taking pain medication for as long as possible prior to surgery. During the operation, heating pads were used to maintain body temperature. The temperature of the operating room was controlled to 23°C, and the temperature of the irrigation fluid in the joint cavity was controlled to 36°C. The patient’s blood pressure was controlled and lowered as necessary, the levels of perioperative fluid input and perfusion were limited, and no drainage tubes were placed at the end of the operation. Patients were placed in the same shoulder brace as after operation, nonsteroidal anti-inflammatory drugs were administered for pain management, and hot and cold wet compresses were applied intermittently. Patients were instructed to perform the same functional rehabilitation exercises under the supervision of a rehabilitation physician. In addition, psychological guidance and distraction techniques were provided.Although some of the perioperative interventions differed between groups, all postoperative rehabilitation measures were the same and were therefore treated as constants in the present study. In order to elucidate the effects of ERAS and ISB interventions, the remaining interventions had to be as consistent as possible to minimize errors in the study results. Other than the application of ISB, the perioperative management of patients in Group C was identical to that of Group B.