Objectives The aim of this study was to describe the early experience with ERAS protocols for gynecologic surgeries at an urban academic tertiary medical center.

Methods The target population was the women who underwent various types of gynecologic surgeries for both benign and malignant diseases between October 2020 and January 2021. Two separate analyses were performed: a case-matched analysis between ERAS vs. non-ERAS cohorts and a retrospective cohort comparative analysis between ERAS vs. historical non-ERAS comparison groups.

Results A total of 200 patients were evaluated (122 patients in the ERAS group vs. 78 patients in the non-ERAS group). Fasting times were significantly shorter in the ERAS cohort group (26.3 vs. 40.1 hours for solid food, 6.9 vs. 15.4 hours for clear liquid in the ERAS group vs. non-ERAS group, both p-values < 0.01). The use of opioid analgesia was also significantly lower (0.3 vs. 1.8 vials in the ERAS group vs. non-ERAS group, p-value <0.01), whereas NSAIDs and acetaminophen use was more frequent in the ERAS group. The patients in the ERAS group reported less post-operative pain, feelings of hunger and thirst, and greater amount of exercise. The length of hospital stay did not differ between the two groups. These benefits of the ERAS protocols were more significant in the patients who underwent laparotomic surgeries than those who underwent laparoscopic surgeries. Similar patterns of the results were observed from the historical comparison analysis.

Conclusions The ERAS protocols improved post-operative recovery after various gynecologic surgeries.