Abstract
Background: Enhanced Recovery After Surgery (ERAS) protocols have been widely adopted in many surgical disciplines, yet their application in orthognathic surgery remains limited.
Objective: To evaluate current evidence on ERAS protocol implementation in orthognathic surgery, examining impacts on pain control, opioid use, postoperative nausea and vomiting (PONV), hospital stay, and recovery.
Methods: A systematic review of six clinical studies (n = 986) was conducted using PRISMA and GRADE frameworks.
Results: ERAS implementation reduced opioid use, pain scores, PONV incidence, and hospital length of stay. The strongest evidence supported scheduled non-opioid analgesia and risk-stratified antiemetic prophylaxis. Evidence for mobilisation, nutrition, and discharge planning was limited.
Conclusions: ERAS protocols in orthognathic surgery improve early postoperative outcomes and patient experience. Future research should focus on standardizing protocols and exploring long-term outcomes.