Enhanced Recovery After Surgery (ERAS) for Orthognathic Surgery: A Critical Evaluation of Protocols, Outcomes and Future Directions

Article Sidebar

pdf
Published Dec 1, 2025
DOI: https://doi.org/10.18103/mra.v13i11.7036

Downloads

Download data is not yet available.

Submit your own article

Register as an author to reserve your spot in the next issue of the Medical Research Archives.

Author Registration

Join the Society

The European Society of Medicine is more than a professional association. We are a community. Our members work in countries across the globe, yet are united by a common goal: to promote health and health equity, around the world.

Join Europe’s leading medical society and discover the many advantages of membership, including free article publication.

Membership

Main Article Content

Joan Birbe, MD, DDS, PhD
Clínica BIRBE Barcelona, Spain Private Practice

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.

Keywords: Orthognathic surgery; ERAS; enhanced recovery; postoperative pain; opioid reduction; PONV; jaw surgery

Article Details

How to Cite
BIRBE, Joan. Enhanced Recovery After Surgery (ERAS) for Orthognathic Surgery: A Critical Evaluation of Protocols, Outcomes and Future Directions. Medical Research Archives, [S.l.], v. 13, n. 11, dec. 2025. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/7036>. Date accessed: 26 dec. 2025. doi: https://doi.org/10.18103/mra.v13i11.7036.
ABNT APA BibTeX CBE EndNote - EndNote format (Macintosh & Windows) MLA ProCite - RIS format (Macintosh & Windows) RefWorks Reference Manager - RIS format (Windows only) Turabian
Issue
Vol 13 No 11 (2025): Vol.13, Issue 11, November 2025
Section
Research Articles

The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

 

References

1. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997;78(5):606-617.

2. Shauly O, Marxen T, Menon A, et al. Multimodal pain control in abdominoplasty: a systematic review and algorithm of optimal pain management. Aesthet Surg J. 2024;44(S1): S22-S30.

3. Wainwright TW, Gill M, McDonald DA, et al. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: ERAS Society recommendations. Acta Orthop. 2020;91(3):3-19.

4. Bär AK, Werkmeister R, Dort JC, Al-Nawas B. Perioperative care in orthognathic surgery: a systematic review and meta-analysis for Enhanced Recovery After Surgery. J Craniomaxillofac Surg. 2024;52(12):1244-1252.

5. Joachim MV, Miloro M. Enhanced recovery after orthognathic surgery: evidence synthesis for postoperative care. J Oral Maxillofac Surg. 2025;83 (4):412-419.

6. Wahlstrom D, Toscano C, Havard D. Enhanced recovery after orthognathic surgery: a retrospective comparison study of 56 patients. Br J Oral Maxillofac Surg. 2023;61(2):171-175.

7. Alvarez GA, Hebert KJ, Britt MC, et al. An enhanced recovery after surgery (ERAS) protocol for orthognathic surgery reduces rates of postoperative nausea. J Craniofac Surg. 2024;35(4):1125-1128.

8. Ferrara JT, Tehrany GM, Chen Q, et al. Evaluation of an enhanced recovery after surgery protocol (ERAS) for same-day discharge and reduction of opioid use following bimaxillary orthognathic surgery. J Oral Maxillofac Surg. 2022;80(1):38-46.

9. de Oliveira ZSB, da Silveira MLM, Gomes PP, da Silva JSP, Germano AR. Early recovery after surgery protocol in orthognathic surgery: a randomized, blind clinical study. Braz Oral Res. 2021;35:e87.

10. Etemad SA, Poh M. Enhanced recovery after gender- affirming surgery. Aesthet Surg J. 2024;44 (S1):S3-S14.