Synergistic anionic/zwitterionic mixed surfactant system with high emulsification efficiency for enhanced oil recovery in low permeability reservoirs

Emulsification is one of the important mechanisms of surfactant flooding. To improve oil recovery for low permeability reservoirs, a highly efficient emulsification oil flooding system consisting of anionic surfactant sodium alkyl glucosyl hydroxypropyl sulfonate(APGSHS) and zwitterionic surfactant octadecyl betaine(BS-18) is proposed. The performance of APGSHS/BS-18 mixed surfactant system was evaluated in terms of interfacial tension, emulsification capability, emulsion size and distribution, wettability alteration, temperature-resistance and salt-resistance. The emulsification speed was used to evaluate the emulsification ability of surfactant systems, and the results show that mixed surfactant systems can completely emulsify the crude oil into emulsions droplets even under low energy conditions. Meanwhile,the system exhibits good temperature and salt resistance. Finally, the best oil recovery of 25.45% is achieved for low permeability core by the mixed surfactant system with a total concentration of 0.3 wt%while the molar ratio of APGSHS:BS-18 is 4:6. The current study indicates that the anionic/zwitterionic mixed surfactant system can improve the oil flooding efficiency and is potential candidate for application in low permeability reservoirs.

CO_(2)flooding in shale oil reservoir with radial borehole fracturing for CO_(2)storage and enhanced oil recovery

This study introduces a novel method integrating CO_(2)flooding with radial borehole fracturing for enhanced oil recovery and CO_(2)underground storage,a solution to the limited vertical stimulation reservoir volume in horizontal well fracturing.A numerical model is established to investigate the production rate,reservoir pressure field,and CO_(2)saturation distribution corresponding to changing time of CO_(2)flooding with radial borehole fracturing.A sensitivity analysis on the influence of CO_(2)injection location,layer spacing,pressure difference,borehole number,and hydraulic fractures on oil production and CO_(2)storage is conducted.The CO_(2)flooding process is divided into four stages.Reductions in layer spacing will significantly improve oil production rate and gas storage capacity.However,serious gas channeling can occur when the spacing is lower than 20 m.Increasing the pressure difference between the producer and injector,the borehole number,the hydraulic fracture height,and the fracture width can also increase the oil production rate and gas storage rate.Sensitivity analysis shows that layer spacing and fracture height greatly influence gas storage and oil production.Research outcomes are expected to provide a theoretical basis for the efficient development of shale oil reservoirs in the vertical direction.

Research progress and potential of new enhanced oil recovery methods in oilfield development

This paper reviews the basic research means for oilfield development and also the researches and tests of enhanced oil recovery(EOR)methods for mature oilfields and continental shale oil development,analyzes the problems of EOR methods,and proposes the relevant research prospects.The basic research means for oilfield development include in-situ acquisition of formation rock/fluid samples and non-destructive testing.The EOR methods for conventional and shale oil development are classified as improved water flooding(e.g.nano-water flooding),chemical flooding(e.g.low-concentration middle-phase micro-emulsion flooding),gas flooding(e.g.micro/nano bubble flooding),thermal recovery(e.g.air injection thermal-aided miscible flooding),and multi-cluster uniform fracturing/water-free fracturing,which are discussed in this paper for their mechanisms,approaches,and key technique researches and field tests.These methods have been studied with remarkable progress,and some achieved ideal results in field tests.Nonetheless,some problems still exist,such as inadequate research on mechanisms,imperfect matching technologies,and incomplete industrial chains.It is proposed to further strengthen the basic researches and expand the field tests,thereby driving the formation,promotion and application of new technologies.

Experimental investigation on using CO_(2)/H_(2)O emulsion with high water cut in enhanced oil recovery

CO_(2) emulsions used for EOR have received a lot of interest because of its good performance on CO_(2)mobility reduction.However,most of them have been focusing on the high quality CO_(2) emulsion(high CO_(2) fraction),while CO_(2) emulsion with high water cut has been rarely researched.In this paper,we carried out a comprehensive experimental study of using high water cut CO_(2)/H_(2)O emulsion for enhancing oil recovery.Firstly,a nonionic surfactant,alkyl glycosides(APG),was selected to stabilize CO_(2)/H_(2)O emulsion,and the corresponding morphology and stability were evaluated with a transparent PVT cell.Subsequently,plugging capacity and apparent viscosity of CO_(2)/H_(2)O emulsion were measured systematically by a sand pack displacement apparatus connected with a 1.95-m long capillary tube.Furthermore,a high water cut(40 vol%) CO_(2)/H_(2)O emulsion was selected for flooding experiments in a long sand pack and a core sample,and the oil recovery,the rate of oil recovery,and the pressure gradients were analyzed.The results indicated that APG had a good performance on emulsifying and stabilizing CO_(2) emulsion.An inversion from H_(2)O/CO_(2) emulsion to CO_(2)/H_(2)O emulsion with the increase in water cut was confirmed.CO_(2)/H_(2)O emulsions with lower water cuts presented higher apparent viscosity,while the optimal plugging capacity of CO_(2)/H_(2)O emulsion occurred at a certain water cut.Eventually,the displacement using CO_(2)/H_(2)O emulsion provided 18.98% and 13.36% additional oil recovery than that using pure CO_(2) in long sand pack and core tests,respectively.This work may provide guidelines for EOR using CO_(2) emulsions with high water cut.

Is recovery enhancement after gastric cancer surgery really a safe approach for elderly patients?

BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,2023.The mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for analysis.The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores.We used Stata(V.16.0)software for data analysis.RESULTS This study consists of six studies involving 878 elderly patients.By analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.

Enhanced recovery after surgery in elderly patients with non-small cell lung cancer who underwent video-assisted thoracic surgery

BACKGROUND This study was designed to investigate the clinical outcomes of enhanced recovery after surgery(ERAS)in the perioperative period in elderly patients with nonsmall cell lung cancer(NSCLC).AIM To investigate the potential enhancement of video-assisted thoracic surgery(VATS)in postoperative recovery in elderly patients with NSCLC.METHODS We retrospectively analysed the clinical data of 85 elderly NSCLC patients who underwent ERAS(the ERAS group)and 327 elderly NSCLC patients who received routine care(the control group)after VATS at the Department of Thoracic Surgery of Peking University Shenzhen Hospital between May 2015 and April 2017.After propensity score matching of baseline data,we analysed the postoperative stay,total hospital expenses,postoperative 48-h pain score,and postoperative complication rate for the 2 groups of patients who underwent lobectomy or sublobar resection.RESULTS After propensity score matching,ERAS significantly reduced the postoperative hospital stay(6.96±4.16 vs 8.48±4.18 d,P=0.001)and total hospital expenses(48875.27±18437.5 vs 55497.64±21168.63 CNY,P=0.014)and improved the satisfaction score(79.8±7.55 vs 77.35±7.72,P=0.029)relative to those for routine care.No significant between-group difference was observed in postoperative 48-h pain score(4.68±1.69 vs 5.28±2.1,P=0.090)or postoperative complication rate(21.2%vs 27.1%,P=0.371).Subgroup analysis showed that ERAS significantly reduced the postoperative hospital stay and total hospital expenses and increased the satisfaction score of patients who underwent lobectomy but not of patients who underwent sublobar resection.CONCLUSION ERAS effectively reduced the postoperative hospital stay and total hospital expenses and improved the satisfaction score in the perioperative period for elderly NSCLC patients who underwent lobectomy but not for patients who underwent sublobar resection.

Eco-friendly calcium alginate microspheres enable enhanced profile control and oil displacement

Polymer microspheres(PMs),such as polyacrylamide,have been widely applied for enhanced oil recovery(EOR),yet with environmental concerns.Here,we report a microfluid displacement technology containing a bio-based eco-friendly material,i.e.,calcium alginate(CaAlg)microspheres for EOR.Two dominant mechanisms responsible for EOR over Ca Alg fluid have been verified,including the microscopic oil displacement efficacy augmented by regulating capillary force(determined by the joint action of interfacial tension and wettability between different phases)and macroscopic sweep volume increment through profile control and mobility ratio reduction.This comprehensive effectiveness can be further impacted when the CaAlg microsphere is embellished ulteriorly by using appropriate amount of sodium dodecyl sulfonate(SDS).The core flooding and nuclear magnetic resonance(NMR)tests demonstrate that CaAlg-SDS microsphere can balance the interphase property regulation(wettability alteration and IFT reduction)and rheology properties,enabling simultaneous profile control and oil displacement.Excessive introduction of SDS will have a negative impact on rheological properties,which is not favored for EOR.Our results show that the involvement of 4-m M SDS will provide the best behavior,with an EOR rate of 34.38%.This cost-effective and environmentally-friendly bio-microspherebased microfluidic displacement technology is expected to achieve“green”oil recovery in future oilfield exploitation.

Shale oil recovery by CO_(2)injection in Jiyang Depression,Bohai Bay Basin,East China

Laboratory experiments,numerical simulations and fracturing technology were combined to address the problems in shale oil recovery by CO_(2)injection.The laboratory experiments were conducted to investigate the displacement mechanisms of shale oil extraction by CO_(2)injection,and the influences of CO_(2)pre-pad on shale mechanical properties.Numerical simulations were performed about influences of CO_(2)pre-pad fracturing and puff-n-huff for energy replenishment on the recovery efficiency.The findings obtained were applied to the field tests of CO_(2)pre-pad fracturing and single well puff-n-huff.The results show that the efficiency of CO_(2)puff-n-huff is affected by micro-and nano-scale effect,kerogen,adsorbed oil and so on,and a longer soaking time in a reasonable range leads to a higher exploitation degree of shale oil.In the"injection+soaking"stage,the exploitation degree of heavy hydrocarbons is enhanced by CO_(2)through its effects of solubility-diffusion and mass-transfer.In the"huff"stage,crude oil in large pores is displaced by CO_(2)to surrounding larger pores or bedding fractures and finally flows to the production well.The injection of CO_(2)pre-pad is conducive to keeping the rock brittle and reducing the fracture breakdown pressure,and the CO_(2)is liable to filter along the bedding surface,thereby creating a more complex fracture.Increasing the volume of CO_(2)pre-pad can improve the energizing effect,and enhance the replenishment of formation energy.Moreover,the oil recovery is more enhanced by CO_(2)huff-n-puff with the lower shale matrix permeability,the lower formation pressure,and the larger heavy hydrocarbon content.The field tests demonstrate a good performance with the pressure maintained well after CO_(2)pre-pad fracturing,the formation energy replenished effectively after CO_(2)huff-n-puff in a single well,and the well productivity improved.

A salt-induced tackifying polymer for enhancing oil recovery in highsalinity reservoirs:Synthesis,evaluation,and mechanism

Polymerflooding is an effective method widely applied for enhancing oil recovery(EOR)by reducing the mobility ratio between theinjected water and crude oil.However,traditional polymers encounter challenges in high salinity reservoirs due to their salt sensitivity.Toovercome this challenge,we synthesized a zwitterion polymer(PAMNS)with salt-induced tackifying property through copolymerization ofacrylamide and a zwitterion monomer,methylacrylamide propyl-N,N-dimethylbutylsulfonate(NS).NS monomer is obtained from thereaction between 1,4-butanesultone and dimethylamino propyl methylacrylamide.In this study,the rheological properties,salt responsiveness,and EOR efficiency of PAMNS were evaluated.Results demonstrate that PAMNS exhibits desirable salt-induced tackifyingcharacteristics,with viscosity increasing up to 2.4 times as the NaCl concentration reaches a salinity of 30×10^(4)mg L^(-1).Furthermore,highvalence ions possess a much stronger effect on enhancing viscosity,manifested as Mg^(2+)>Ca^(2+)>Na^(+).Molecular dynamics simulations(MD)andfluid dynamics experiment results demonstrate that PAMNS molecules exhibit a more stretched state and enhanced intermolecularassociations in high-salinity environments.It is because of the salt-induced tackifying,PAMNS demonstrates superior performance inpolymerflooding experiments under salinity ranges from 5×10^(4)mg L^(-1)to 20×10^(4)mg L^(-1),leading to 10.38–19.83%higher EOR thantraditional polymers.

Molecular design and applications of a nanostructure green Tripodal surface active ionic liquid in enhanced oil recovery: Interfacial tension reduction, wettability alteration, and emulsification

Surface active ionic liquids (SAILs) are considered as prominent materials in enhanced oil recovery thanks to their high interfacial activity. This study reports the preparation and applications of a nanostructure Tripodal imidazolium SAIL as an environmentally-friendly substitute to the conventional surfactants. The product has a star-like molecular structure centered by a triazine spacer, namely [(C_(4)im)_(3)TA][Cl_(3)], prepared by a one-step synthesis method and characterized with FT-IR, NMR, XRD, and SEM analysis methods. The interfacial tension of the system was decreased to about 78% at critical micelle concentration of less than 0.08 mol·dm^(−3). Increasing temperature, from 298.2 to 323.2 K, improved this capability. The solid surface wettability was changed from oil-wet to water-wet and 80% and 77% stable emulsions of crude oil–aqueous solutions were created after one day and one week, respectively. Compared to the Gemini kind homologous SAILs, the superior effects of the Tripodal SAIL were revealed and attributed to the strong hydrophobic branches in the molecule. The Frumkin adsorption isotherm precisely reproduced the generated IFT data, and accordingly, the adsorption and thermodynamic parameters were determined.

Nanoparticle-reinforced foam system for enhanced oil recovery(EOR):Mechanistic review and perspective

Boosted by economic development and rising living standards,the world's carbon dioxide emissions remain high.Maintaining temperature rises below 1.5℃ by the end of the century requires rapid global carbon capture and storage implementation.The successful application of carbon capture,utilization,and storage(CCUS)technology in oilfields has become the key to getting rid of this predicament.Foam flooding,as an organic combination of gas and chemical flooding,became popular in the 1950s.Notwithstanding the irreplaceable advantages,as a thermodynamically unstable system,foam's stability has long restricted its development in enhanced oil and gas recovery.With special surface/interface effects and small-size effects,nanoparticles can be used as foam stabilizers to enhance foam stability,thereby improving foam seepage and oil displacement effects in porous media.In this paper,the decay kinetics and the stabilization mechanisms of nanoparticle-reinforced foams were systematically reviewed.The effects of nanoparticle characteristics,including particle concentration,surface wettability,particle size,and type,and reservoir environment factors,including oil,temperature,pressure,and salinity on the foam stabilization ability were analyzed in detail.The seepage and flooding mechanisms of nanoparticle-reinforced foams were summarized as:improving the plugging properties of foams,enhancing the interaction between foams and crude oil,and synergistically adjusting the wettability of reservoir rocks.Finally,the challenges in the practical application of nanoparticle-reinforced foams were highlighted,and the development direction was proposed.The development of nanoparticle-reinforced foam can open the way toward adaptive and evolutive EOR technology,taking one further step towards the high-efficiency production of the petroleum industry.

Surface-functionalized cellulose nanocrystals(CNC)and synergisms with surfactant for enhanced oil recovery in low-permeability reservoirs

Nanocellulose,a natural polymeric nanomaterial,has attracted significant attention in enhanced oil recovery(EOR)applications due to its abundance,nanoscale,high oil-water interfacial adsorption ef-ficiency.In this study,surface-functionalized cellulose nanocrystals(SF-CNCs)were prepared via hy-drochloric acid hydrolysis and chemical modification,with adaptable nanosize and considerable dispersion stability in low-permeability reservoirs.The SF-CNCs were structurally characterized by FT-IR,Cryo-TEM,which have a diameter of 5-10 nm and a length of 100-200 nm.The SF-CNC dispersions possessed higher stability and stronger salt-tolerance than those of corresponding CNC dispersions,due to the strong hydrophilicity of the sulfonic acid group.It was synergistically used with a non-ionic surfactant(APG1214)to formulate a combined flooding system(0.1 wt%SF-CNC+0.2 wt%APG1214).The combined flooding system exhibits strong emulsification stability,low oil-water interfacial tension of o.03 mN/m,and the ability to alter the wettability for oil-wetting rocks.Furthermore,the combined system was_able to provide an optimum EOR efficiency of 20.2%in low-permeability cores with 30.13×10^(-3)μm^(2).Notably.it can enlarge the sweep volume and increase the displacement efficiency simultaneously.Overall,the newly formulated nanocellulose/surfactant combined system exhibits a remarkable EoR performance in low-permeability reservoirs.

Gas channeling control with an in-situ smart surfactant gel during water-alternating-CO_(2) enhanced oil recovery

Undesirable gas channeling always occurs along the high-permeability layers in heterogeneous oil reservoirs during water-alternating-CO_(2)(WAG)flooding,and conventional polymer gels used for blocking the“channeling”paths usually suffer from either low injectivity or poor gelation control.Herein,we for the first time developed an in-situ high-pressure CO_(2)-triggered gel system based on a smart surfactant,N-erucamidopropyl-N,N-dimethylamine(UC22AMPM),which was introduced into the aqueous slugs to control gas channeling inWAG processes.The water-like,low-viscosity UC22AMPM brine solution can be thickened by high-pressure CO_(2) owing to the formation of wormlike micelles(WLMs),as well as their growth and shear-induced structure buildup under shear flow.The thickening power can be further potentiated by the generation of denser WLMs resulting from either surfactant concentration augmentation or a certain range of heating,and can be impaired via pressurization above the critical pressure of CO_(2) because of its soaring solvent power.Core flooding tests using heterogeneous cores demonstrated that gas channeling was alleviated by plugging of high-capacity channels due to the in-situ gelation of UC22AMPM slugs upon their reaction with the pre-or post-injected CO_(2) slugs under shear flow,thereupon driving chase fluids into unrecovered low-permeability areas and producing an 8.0% higher oil recovery factor than the conventional WAG mode.This smart surfactant enabled high injectivity and satisfactory gelation control,attributable to low initial viscosity and the combined properties of one component and CO_(2)-triggered gelation,respectively.This work could provide a guide towards designing gels for reducing CO_(2) spillover and reinforcing the CO_(2) sequestration effect during CO_(2) enhanced oil recovery processes.

Does enhanced recovery after surgery programs improve clinical outcomes in liver cancer surgery?

Enhanced recovery after surgery(ERAS)programs have been widely applied in liver surgery since the publication of the first ERAS guidelines in 2016 and the new recommendations in 2022.Liver surgery is usually performed in oncological patients(liver metastasis,hepatocellular carcinoma,cholangiocarcinoma,etc.),but the real impact of liver surgery ERAS programs in oncological outcomes is not clearly defined.Theoretical advantages of ERAS programs are:ERAS decreases postoperative complication rates and has been demonstrated a clear relationship between complications and oncological outcomes;a better and faster posto-perative recovery should let oncologic teams begin chemotherapeutic regimens on time;prehabilitation and nutrition actions before surgery should also improve the performance status of the patients receiving chemotherapy.So,ERAS could be another way to improve our oncological results.We will discuss the literature about liver surgery ERAS focusing on its oncological implications and future investigations projects.

Innovations and applications of the thermal recovery techniques for heavy oil

Heavy oil represents a vital petroleum resource worldwide.As one of the major producers,China is facing great challenges in effective and economic production of heavy oil due to reservoir complexity.Plenty of efforts have been made to promote innovative advances in thermal recovery modes,methods,and processes for heavy oil in the country.The thermal recovery mode has been shifted from simple steam injection to a more comprehensive“thermal+"strategy,such as a novel N2-steam hybrid process and CO_(2)-enhanced thermal recovery techniques.These advanced techniques break through the challenges of heavy oil extraction from less accessible reservoirs with thinner oil layers and greater burial depths.Regarding thermal recovery methods,China has developed the steam-assisted gravity drainage method integrating flooding and drainage(also referred to as the hybrid flooding-drainage SAGD technology)for highly heterogeneous ultra-heavy oil reservoirs and the fire flooding method for nearly depleted heavy oil reservoirs,substantially improving oil recovery.Furthermore,a range of processes have been developed for heavy oil production,including the open hole completion process using sand control screens for horizontal wells,the process of integrated injection-recovery with horizontal pump for horizontal wells,the steam dryness maintenance,measurement,and control process,efficient and environment-friendly circulating fluidized bed(CFB)boilers with high steam dryness,the recycling process of produced water,and the thermal recovery process for offshore heavy oil.Based on the advances in methodology,technology,and philosophy,a series of supporting technologies for heavy oil production have been developed,leading to the breakthrough of existing technical limit of heavy oil recovery and the expansion into new exploitation targets.For the future heavy oil production in China,it is necessary to embrace a green,low-carbon,and energy-efficient development strategy,and to expand heavy oil extraction in reservoirs with larger burial depth,more viscous oil,thinner oil layers,and lower permeability.Moreover,it is highly recommended to collaboratively maximize oil recovery and oil-to-steam ratio through technological innovations,and boost intelligentization of heavy oil production.

Safety and feasibility of enhanced recovery after surgery-based management model for ambulatory pediatric surgical procedures

BACKGROUND There is still some room for optimizing ambulatory pediatric surgical procedures,and the preoperative and postoperative management quality for pediatric patients needs to be improved.AIM To discuss the safety and feasibility of the enhanced recovery after surgery(ERAS)-based management model for ambulatory pediatric surgical procedures.METHODS We selected 320 pediatric patients undergoing ambulatory surgery from June 2023 to January 2024 at The First People’s Hospital of Liangshan Yi Autonomous Prefecture.Of these,220 received ERAS-based management(research group)and 100 received routine management(control group).General information,postoperative ambulation activities,surgical outcomes(operation time,postoperative gastro-intestinal ventilation time,and hospital stay),postoperative pain visual analogue scale,postoperative complications(incision infection,abdominal distension,fever,nausea,and vomiting),and family satisfaction were compared.RESULTS The general information of the research group(sex,age,disease type,single parent,family history,etc.)was comparable to that of the control group(P>0.05),but the rate of postoperative(2 h,4 h,and 6 h after surgery)ambulation activities was statistically higher(P<0.01),and operation time,postoperative gastrointestinal ventilation time,and hospital stay were markedly shorter(P<0.05).The research group had lower visual analogue scale scores(P<0.01)at 12 h and 24 h after surgery and a lower incidence of total postoperative complications than the control group(P=0.001).The research group had higher family satisfaction than the control group(P=0.007).CONCLUSION The ERAS-based management model was safe and feasible in ambulatory pediatric surgical procedures and worthy of clinical promotion.

Enhanced recovery after surgery:Progress in adapted pathways for implementation in standard and emerging surgical settings

The concept of enhanced recovery after surgery(ERAS)has been practiced for decades and has been implemented in numerous surgical specialties.ERAS is a global surgical quality improvement initiative,and it is an element in the field of perioperative care.ERAS had shown significant clinical outcomes,patientreported satisfaction,and improvements in medical service cost.ERAS has been developed for specific surgical procedures,but with the fast progress of newly introduced surgical procedures,the original ERAS have been developed and modified.Recently appearing Topics and future research trends encompass ERAS protocols for other types of surgery and the enhancement of perioperative status,including but not limited to pediatric surgery,laparoscopic and robotic assisted surgery,bariatric surgery,thoracic surgery,and renal transplantation.The elements and pathways of ERAS have been developed with the introduction of up-to-date methodologies in the pre-operative,operative,and post-operative pathways.ERAS costs are higher than traditional care,but the patient’s clinical outcome and satisfaction are higher.ERAS is in progress in the fields of anesthetic tasks,pediatric surgery,and organ transplantation.Although ERAS has shown significant clinical outcomes,there are needs to modify the protocol for specific cases,hospital facilities,resources,and nurses training on elements of ERAS.Several challenges and limitations exist in the implementation of ERAS that deserve consideration,it includes:Frailty,maximizing nutrition,prehabilitation,treating preoperative anemia,and enhancing ERAS adoption globally are all included.

Clinical study of enhanced recovery after surgery in laparoscopic appendectomy for acute appendici

BACKGROUND Enhanced recovery after surgery(ERAS)protocol is a comprehensive manage-ment modality that promotes patient recovery,especially in the patients undergo-ing digestive tumor surgeries.However,it is less commonly used in the appen-dectomy.AIM To study the application value of ERAS in laparoscopic surgery for acute appen-dicitis.METHODS A total of 120 patients who underwent laparoscopic appendectomy due to acute appendicitis were divided into experimental group and control group by random number table method,including 63 patients in the experimental group and 57 patients in the control group.Patients in the experimental group were managed with the ERAS protocol,and those in the control group were received the tra-ditional treatment.The exhaust time,the hospitalization duration,the hospita-lization expense and the pain score between the two groups were compared.RESULTS There was no significant difference in age,gender,body mass index and Sunshine Appendicitis Grading System score between the experimental group and the con-trol group(P>0.05).Compared to the control group,the patients in the expe-rimental group had earlier exhaust time,shorter hospitalization time,less hospi-talization cost and lower degree of pain sensation.The differences were statis-tically significant(P<0.01).CONCLUSION ERAS could significantly accelerate the recovery of patients who underwent la-paroscopic appendectomy for acute appendicitis,shorten the hospitalization time and reduce hospitalization costs.It is a safe and effective approach.

Enhanced recovery after surgery-based nursing in older patients with postoperative intestinal obstruction after gastric cancer surgery:A retrospective study

BACKGROUND Gastric cancer-related morbidity and mortality rates are high in China.Patients who have undergone gastric cancer surgery should receive six cycles of chemotherapy according to their condition.During this period,intestinal obstruction is likely to occur.Electrolyte balance disorders,peritonitis,intestinal necrosis,and even hypovolemic shock and septic shock can seriously affect the physical and mental recovery of patients and threaten their health and quality of life(QoL).AIM To quantitatively explore the effects of enhanced recovery after surgery(ERAS)-based nursing on anxiety,depression,and QoL of elderly patients with postoperative intestinal obstruction after gastric cancer.METHODS The clinical data of 129 older patients with intestinal obstruction after gastric cancer surgery who were treated and cared for in our hospital between January 2019 and December 2021 were examined retrospectively.Nine patients dropped out because of transfer,relocation,or death.According to the order of admissions,the patients were categorized into either a comparison group or an observation group according to the random number table,with 60 cases in each group.RESULTS After nursing care,the observation group required significantly less time to eat for the first time,recover bowel sounds,pass gas,and defecate than the comparison group(P<0.05).No significant difference was noted in nutrition-related indicators between the two groups before care.Before care,the Symptom Check List-90 scores between the two groups were comparable,whereas anxiety,depression,paranoia,fear,hostility,obsession,somatization,interpersonal sensitivity,and psychotic scores were significantly lower in the observation group after care(P<0.05).The QoL scores between the two groups before care did not differ significantly.After care,the physical,social,physiological,and emotional function scores;mental health score;vitality score;and general health score were significantly higher in the observation group,whereas the somatic pain score was significantly lower in the observation group(P<0.05).CONCLUSION ERAS-based nursing combined with conventional nursing interventions can effectively improve patient’s QoL,negative emotions,and nutritional status;accelerate the time to first ventilation;and promote intestinal function recovery in elderly patients with postoperative intestinal obstruction after gastric cancer surgery.

Optimizing outcomes:Implementing enhanced recovery after surgery in orthopedic surgery

In the realm of orthopedics,the adoption of enhanced recovery after surgery(ERAS)protocols marks a significant stride towards enhancing patient well-being.By embracing a holistic approach that encompasses preoperative counseling,dietary optimization,minimally invasive procedures,and early postoperative mobilization,these protocols have ushered in a new era of surgical care.Despite encountering hurdles like resistance to change and resource allocation challenges,the efficacy of ERAS protocols in improving clinical outcomes is undeniable.Noteworthy benefits include shortened hospital stays and bolstered improved patient-safety measures.Looking ahead,the horizon for ERAS in orthopedics appears bright,with an emphasis on tailoring care to individual needs,integrating cutting-edge technologies,and perpetuating research endeavors.This shift towards a more personalized,streamlined,and cost-efficient model of care underscores the transformative potential of ERAS in reshaping not only orthopedic surgery but also the journey to patient recovery.This editorial details the scope and future of ERAS in the orthopedic specialty.