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We describe an ESS ERAS protocol including key perioperative interventions for patients undergoing ESS\u00a0and assess the available evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>A search was conducted of all relevant ERAS literature in otorhinolaryngology, anesthesia, and surgery using Medline (via PubMed), and Scopus. Keywords included \u201cendoscopic sinus surgery,\u201d\u00a0\u201csinus surgery,\u201d\u00a0\u201cFESS,\u201d\u00a0and \u201cESS\u201d for each area of intervention. Where applicable, the authors considered high\u2010level evidence for recommendations devised for patient cohorts in otorhinolaryngology not undergoing ESS, as well as cohorts undergoing surgical procedures for which ERAS protocols have been extensively evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Studies received grades of \u201clow,\u201d\u00a0\u201cmoderate,\u201d\u00a0or \u201chigh\u201d quality evidence based on the Oxford Centre for Evidence\u2010Based Medicine criteria. Each intervention was subsequently assigned a grade of \u201cstrong,\u201d\u00a0\u201cweak,\u201d\u00a0or \u201cconditional\u201d based on the available evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Strong recommendations include comprehensive patient education and counseling, minimization of preoperative fasting, application of topical\/local anesthetics and vasoconstrictors, use of total intravenous anesthesia, avoidance of pharyngeal packing, and use of postoperative nasal irrigation and multimodal analgesia. Conditional recommendations include antibiotic prophylaxis. Weak recommendations include perioperative venous thromboembolism prophylaxis, controlled hypotension, and use of postoperative nasal packing\/dressing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A comprehensive ERAS protocol for ESS can include a variety of high yield, evidence\u2010based interventions that would likely improve surgical outcomes and patient satisfaction.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjo2.166","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T07:39:59Z","timestamp":1711006799000},"page":"147-157","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Enhanced recovery after endoscopic sinus surgery: Establishing comprehensive protocols for improvement of perioperative patient care"],"prefix":"10.1002","volume":"11","author":[{"given":"Louis\u2010Xavier","family":"Barrette","sequence":"first","affiliation":[{"name":"Department 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