<![CDATA[ABSTRACT Patients undergoing elective or urgent/incidental surgery are at risk of delayed postoperative recovery due to the surgical stress response, pain, immobilization, and postoperative complications. The Enhanced Recovery After Surgery (ERAS) protocol was developed as an integrated, evidence-based perioperative care approach to minimize the impact of surgical stress and accelerate patient recovery. This study analyzes the effectiveness of implementing the ERAS protocol as a strategy to accelerate recovery for patients undergoing elective surgery. A literature review approach was employed. Search terms were defined based on the research question using Medical Subject Headings (MeSH) guidelines to identify relevant keywords. Article searches were conducted across the international databases Scopus, PubMed, and ScienceDirect. All retrieved articles were screened based on their titles and abstracts to determine their relevance to the research topic. Articles meeting the initial criteria were subsequently screened and analyzed for inclusion in or exclusion from the literature review based on methodological quality, topic relevance, and alignment with research objectives and questions. In the next stage, researchers read the full text of the articles and analyzed those meeting the established inclusion and exclusion criteria. The article selection process was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data extraction was then performed on the selected articles, covering author names, publication years, study designs, sample characteristics, types of interventions or approaches used, and key research findings. Subsequently, the quality of the articles was assessed to ensure the validity and strength of evidence for each included study. The extracted data were analyzed and synthesized both narratively and thematically, grouping findings based on similarities in concepts, approaches, and research outcomes. The synthesis results are presented descriptively to address the research objectives and questions. The literature search identified five studies meeting the inclusion criteria, encompassing various study designs and elective surgery contexts. The synthesis of evidence indicates that the consistent implementation of Enhanced Recovery After Surgery (ERAS) protocols is associated with a reduction in the length of stay (LOS) compared to conventional perioperative care, with the magnitude of the reduction ranging from 1 to 3 days. The reduction in length of stay (LOS) is primarily attributed to the implementation of core ERAS components—such as preoperative education, reduced fasting duration, non-opioid multimodal analgesia, early mobilization, and early oral nutrition—which can be widely implemented across various healthcare settings. ERAS is an effective, evidence-based approach for accelerating postoperative recovery in elective surgery patients, with high-quality evidence supporting its implementation across diverse healthcare contexts. These findings establish a robust foundation for future quasi-experimental research evaluating ERAS effectiveness across various institutional settings, with the identified variables and core components providing a framework for subsequent study designs. Keywords: “Enhanced Recovery After Surgery” oR “ERAS protocol”, “Perioperative care” oR “Postoperative recovery” oR “Length of stay”. ABSTRAK Pasien yang menjalani operasi elektif maupun urgent/insidental berisikomengalami pemulihan pascaoperasi yang lambat akibat respons stres pembedahan, nyeri, imobilisasi, serta komplikasi pascaoperatif. Protokol Enhanced Recovery After Surgery (ERAS) dikembangkan sebagai pendekatan perawatan perioperatif berbasis bukti yang terintegrasi untuk meminimalkan dampak stres pembedahan dan mempercepat proses pemulihan pasien. Menganalisa efektivitas implementasi protokol ERAS sebagai strategi percepatan pemulihan pasien operasi elektif. Tinjauan pustaka ini menggunakan pendekatan literature review. Penulis menentukan istilah pencarian sesuai dengan pertanyaan penelitian menggunakan pedoman Medical Subject Headings (MeSH) untuk mengidentifikasi kata kunci yang relevan. Pencarian artikel dilakukan pada database internasional Scopus, PubMed, dan ScienceDirect. Seluruh artikel yang diperoleh dari hasil pencarian diseleksi berdasarkan judul dan abstrak untuk mengidentifikasi kesesuaian dengan topik penelitian. Artikel yang memenuhi kriteria awal selanjutnya disaring dan dianalisis untuk dimasukkan atau dikeluarkan dari tinjauan pustaka berdasarkan kualitas metodologi, relevansi dengan topik, serta kesesuaian dengan tujuan dan pertanyaan penelitian.Tahap selanjutnya, peneliti membaca artikel secara full text dan menganalisis artikel yang memenuhi kriteria inklusi dan eksklusi yang telah ditetapkan. Proses seleksi artikel dilakukan dengan menggunakan panduan Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA). Artikel yang terpilih kemudian dilakukan proses ekstraksi data, meliputi nama penulis, tahun publikasi, desain penelitian, karakteristik sampel, jenis intervensi atau pendekatan yang digunakan, serta hasil utama penelitian. Selanjutnya dilakukan penilaian kualitas artikel untuk memastikan validitas dan kekuatan bukti dari setiap studi yang diikutsertakan. Data yang telah diekstraksi kemudian dianalisis dan disintesis secara naratif dan tematik, dengan mengelompokkan temuan berdasarkan kesamaan konsep, pendekatan, dan hasil penelitian. Hasil sintesis disajikan dalam bentuk deskriptif untuk menjawab tujuan dan pertanyaan penelitian. Pencarian literatur mengidentifikasi lima studi yang memenuhi kriteria inklusi, mencakup berbagai desain penelitian dan konteks bedah elektif. Sintesis bukti menunjukkan bahwa penerapan protokol Enhanced Recovery After Surgery (ERAS) secara konsisten berhubungan dengan penurunan lama rawat inap (length of stay/LOS) dibandingkan perawatan perioperatif konvensional, dengan besaran penurunan berkisar antara 1 hingga 3 hari. Penurunan LOS terutama dikaitkan dengan penerapan komponen inti ERAS, termasuk edukasi praoperatif, pengurangan durasi puasa, analgesia multimodal non-opioid, mobilisasi dini, dan pemberian nutrisi oral dini, yang dapat diimplementasikan secara luas di berbagai pengaturan layanan kesehatan. ERAS merupakan pendekatan yang efektif dan berbasis bukti untuk mempercepat pemulihan pascaoperasi pada pasien operasi elektif, dengan bukti berkualitas tinggi mendukung implementasi di berbagai konteks layanan kesehatan. Temuan ini menetapkan fondasi yang kuat untuk penelitian quasi-eksperimental di masa depan yang mengevaluasi efektivitas ERAS di berbagai pengaturan institusional, dengan variabel dan komponen inti yang teridentifikasi memberikan kerangka untuk desain penelitian selanjutnya. Kata Kunci: “Enhanced Recovery After Surgery” oR “ERAS protocol”, “Perioperative care” oR “Postoperative recovery” oR “Length of stay”Length of stay.]]>
