Multivitamin Use in Enhanced Recovery After Surgery Protocols: A Cost Analysis

ABSTRACT Introduction Enhanced Recovery After Surgery (ERAS) protocols have shown significant benefits in multiple areas including early mobilization, improved pain control, and oral intake. Deficient nutritional states may compromise the operative outcomes. Several essential vitamins, e.g., B12, C, D, E, demonstrated anti-inflammatory properties promote wound healing. Given low risk of multivitamin supplementation potential benefits, we hypothesized that adding a to our institution’s ERAS would be low-cost perioperative intervention accounting for very small fraction annual pharmacy budget. Methods A cost analysis vitamin all adult orthopedic surgical cases fiscal year 2018 was conducted. To assess period, budget current costs multivitamins were obtained from hospital pharmacy. Medication medical logistics ordering system at per unit (i.e., bottle) tablet levels formulary multivitamins. We also determined number facility surgery scheduling system. The single day (day surgery), 1 week (first postoperative week), 6 weeks plus preop, months preop then calculated. Results Our $123 million dollars with two on formulary. Prenatal tablets, containing vitamins A-E, calcium, iron, zinc, $1.52 bottle 100 tablets $0.0152 tablet, while renal formulation water-soluble B $2.79 $0.0279 tablet. For one year, medication supplement every patient an day, week, range $60.47 $110.99, $423.29 $776.93, $2,963.03 $5,438.51, $10,582.25 $19,423.25, respectively, depending which prescribed. These represent between 0.00005% 0.00009% 0.0003% 0.0006% 0.00245% 0.441% 0.00875% 1.575% respectively. Discussion/Conclusions relative nutrient-deficient state decreased intake contributes metabolic derangements resulting surgery. help mitigate this feeding, addition enhance process. Multivitamins are safe, widely accessible, inexpensive, investigations control healing encouraging results. Further prospective studies needed incorporating into order elucidate effective dosages, duration treatment, effect