Correspondence to Author: Gustavo Couto Gomes¹, Gabriel Leonardo Saraiva², Mariana Ribeiro Gonçalves ², Daniel Freitas dos Santos ², Talita Renata Quirino Lopes², Douglas Hipólito Carvalho¹, Larissa Lauretto³, Délio Tiago Martins Malaquias², Mauricio Martinez Puglia²,Thalita Pinheiro Morel Alineri³, Liliana Martins Occulate⁴, José Carlos Ferreira da Silva², Maria Victoria Moncada Xavier⁵, Giovana Casarini Yamashiro¹, Guilherme Pio Vilela¹, Ana Paula Mendes de Oliveira Kachar², Filipe Jabur Lot Garcia², Rubens Rodrigues Tudela⁶, Regilane da Silva Batista², Robson Ferreira Izaias², Roselene de Oliveira Carvalho², Silvia Alves da Silva Carvalho², Marco Aurélio Silva Couto², Rafaela Ribeiro Bari², Carlos Henrique Batista Figueiredo de Mendonça⁷, Ana Paula Figueiredo Silva ⁸, Anna Júlia Coutinho Costa⁸, Ana Laura Nogueira Ervilha⁸, Thiago Augusto Rochetti Bezerra⁹. 

¹ Nove de Julho University (UNINOVE), São Bernardo do Campo Campus, São Paulo, Brazil.
² Ribeirão Preto University (UNAERP), Guarujá Campus, São Paulo, Brazil.
³ University of Western São Paulo (UNOESTE), Guarujá Campus, São Paulo, Brazil.
⁴ Central University of Paraguay, School of Medicine, Ciudad del Este, Paraguay.
⁵ Faceres University Center (FACERES), São José do Rio Preto, São Paulo, Brazil.
⁶ São Judas Tadeu University, Cubatão Campus, São Paulo, Brazil.
⁷ Federal University of Roraima (UFRR), Boa Vista, Roraima, Brazil.
⁸ São José dos Campos School of Medical Sciences – Humanitas (FCMSJC), São José dos Campos, São Paulo, Brazil.
⁹ Ribeirão Preto School of Medicine, University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.

DOI: 10.52338/wjcsr.2026.5388

Abstract:

ERAS (Enhanced Recovery After Surgery) Protocols have established themselves as an evidence-based approach aimed at optimizing perioperative care, focusing on the integration of surgical, anesthetic, and multidisciplinary practices and promoting patient safety. This study aimed to analyze the importance of ERAS protocols in surgical and anesthetic integration and their impact on patient safety in the operating room through a review of the scientific literature. This is an integrative review conducted in accordance with PRISMA recommendations, searching national and international databases using descriptors related to ERAS, patient safety, anesthesia, and perioperative care. The included studies show that the implementation of ERAS Protocols is associated with a reduction in intraoperative and postoperative adverse events, decreased use of opioids, better pain control, less variability in care, and a stronger culture of safety. The standardization of procedures, multimodal analgesia, rational use of anesthetic drugs, individualized fluid management, adequate monitoring, and multidisciplinary integration stand out as central components of ERAS. In addition, the protocols have demonstrated applicability in various surgical specialties, with adaptations according to the clinical and organizational context. It is concluded that ERAS protocols are an effective strategy for improving patient safety and the quality of perioperative care, reinforcing the need for their systematic and sustained implementation in health services.

Keywords: Enhanced Recovery After Surgery; Patient Safety; Anesthesia; Perioperative Care; Clinical Protocols.

Citation:

Dr. Thiago Augusto Rochetti Bezerra, Integrative Review on the Importance of ERAS (Enhanced Recovery After Surgery) Protocols: Surgical and Anesthetic Integration and Patient Safety in the Operating Room. World Journal of Clinical Surgery 2026.