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Enhanced Recovery After Surgery (ERAS) protocols have become the gold standard for elective colorectal
surgeries, offering significant improvements in patient outcomes. However, their application in emergency gastrointestinal
surgeries remains underexplored. This study examines the feasibility, adherence, and impact of ERAS protocols in
emergency settings, focusing on postoperative recovery and compliance challenges. Methods: Conducted at Navodaya
Medical College, Raichur, Karnataka, this study involved 200 patients undergoing emergency abdominal surgeries between
2008 and 2009. ERAS-specific strategies were implemented, emphasizing postoperative milestones such as early
nasogastric tube removal, mobilization, and initiation of oral nutrition. Data were collected using standardized ERAS forms
and analyzed for compliance, complications, and recovery outcomes using regression models. Results: Key ERAS elements,
including preventing postoperative nausea and vomiting (45.5%) and early mobilization, were widely adhered to. Minimally
invasive techniques were employed in 40% of cases, with significant benefits observed in recovery outcomes (p = 0.04).
Postoperative complications, including morbidity (30%) and mortality (3%), were effectively mitigated. Delayed recovery
was associated with preoperative hyperglycemia (p = 0.002) and excessive postoperative fluid administration (p < 0.001).
The study demonstrated that achieving postoperative milestones by day 7 significantly reduced hospital stays (median 8
days, IQR: 6–12). Conclusions: ERAS protocols are effective in improving outcomes for emergency gastrointestinal
surgeries, demonstrating reduced morbidity, shorter hospital stays, and enhanced recovery trajectories. While challenges
such as fluid overload and hyperglycemia necessitate tailored strategies, the study highlights the importance of broader
adoption and compliance with ERAS protocols in emergency surgical settings. These findings advocate for the
establishment of ERAS as a cornerstone of emergency surgical care
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