Enhanced Recovery After Surgery (ERAS) protocols are multidisciplinary, perioperative care pathways designed to achieve early recovery for patients undergoing major surgery once the decision to operate has been determined. Over the past two decades, groups worldwide have demonstrated the success of protocols across a variety of service lines in adults. Despite growing interest in pediatric ERAS protocols, however, robust research on pediatric applications has been sparse.

Teams establishing pediatric ERAS protocols face many of the same barriers and obstacles as adult teams, such as traditional silos of care, old beliefs and practices of perioperative team members, and preconceived expectations of patients and families. There is also the perceived impact on O.R. efficiency from front-line staff who may already feel overwhelmed with workload and time constraints. On the other hand, there are several pediatric-specific barriers that are, at...

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