title: Spanish survey on enhanced recovery after surgery.
abstract: BACKGROUND
  The aim of this study was to determine the interest in ERAS protocols, and the extent to which clinicians are familiar with and apply these protocols during perioperative care.
  
  
  METHODS
  Free access survey hosted on the Spanish Society of Anesthesiology and Critical Care; Spanish Association of Surgeons and Spanish Society of Enteral and Parenteral nutrition and ERAS Spain (GERM) websites conducted between September and December 2014.
  
  
  RESULTS
  The survey was answered by 272 professionals (44.5% anaesthetists, 45.2% general surgeons) from 110 hospitals, 73% of whom had experience in ERAS protocols. Most (86.1%) had specific knowledge of ERAS protocols, whereas only 50.9% were familiar with ERAS recommendations and 42.4% with GERM recommendations. Most (73.1%) respondents reported that ERAS protocols are performed in their hospitals, mainly in colorectal surgery (93%), and 52.2% reported that GERM/ERAS recommendations are followed. Nearly all (95.5%) would be interested in the development of multidisciplinary national guidelines. Less than half (46.6%) perform preoperative nutritional assessment, albeit without a universal malnutrition screening method (56.8%). Preoperative loading with carbohydrate drinks is carried out in only 51.4% of cases; nasogastric tube and drainage are avoided (79.3%), prophylaxis for postoperative nausea and vomiting (73.4%), goal directed fluid therapy (73.3%), and active normothermia maintenance (87.4%) are performed. In most cases, mobilization (90.1%) and early feeding (87.9%) are performed. The leading causes of protocol failure are postoperative nausea and vomiting (46.5%) and ileus (58.9%).
  
  
  CONCLUSIONS
  Clinicians in Spain are familiar with fast track protocols, although there is no overall consensus, and hospitals do not adhere to existing guidelines. Overall compliance with the items of the protocol is adequate, although perioperative nutritional management is poor.
authors.affiliation: Department of Anesthesia, Infanta Leonor University Hospital, Complutense University of Madrid, Madrid, Spain. Electronic address: ripo542@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Ripollés-Melchor
authors.affiliation: Department of Anesthesia, Lozano Blesa University Hospital, University of Zaragoza, Zaragoza, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Casans-Francés
authors.affiliation: Department of Anesthesia, La Paz University Hospital, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Abad-Gurumeta
authors.affiliation: Department of Anesthesia, La Paz University Hospital, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Suárez-de-la-Rica
authors.affiliation: Department of Surgery, Lozano Blesa University Hospital, University of Zaragoza, Zaragoza, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Ramírez-Rodríguez
authors.affiliation: Department of Anesthesia, Clínico San Carlos University Hospital, Complutense University of Madrid, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: López-Timoneda
authors.affiliation: Department of Anesthesia, Infanta Leonor University Hospital, Complutense University of Madrid, Madrid, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Calvo-Vecino
mesh_terms: D006801:Humans; D007902:Length of Stay; D019990:Perioperative Care; D020250:Postoperative Nausea and Vomiting; D013030:Spain; D011795:Surveys and Questionnaires
keywords: Cuidados perioperatorios; Encuesta; Enhanced recovery after surgery; Fast track surgery; Perioperative care; Recuperación abdominal intensificada; Recuperación intensificada; Survey