• Giovanni Grasso, Manfredi Noto, Lorenzo Pescatori, Marcello Sallì, Hyeun-Sung Kim, Gaia Teresi, and Fabio Torregrossa.
• Neurosurgical Unit, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy. Electronic address: giovanni.grasso@unipa.it.
• World Neurosurg. 2024 May 1; 185: e1013e1018e1013-e1018.

BackgroundEnhanced recovery after surgery (ERAS) is a multidisciplinary approach aimed at reducing the length of hospital stay, improving patient outcomes, and reducing the overall cost of care. Although ERAS protocols have been widely adopted in various surgical fields, their application in cranial surgery remains relatively limited.MethodsConsidering that the aging of the population presents significant challenges to healthcare systems, and there is currently no ERAS protocol available for geriatric patients over the age of 65 requiring cranial surgery, this article proposes a new ERAS protocol for this population by analyzing successful ERAS protocols and optimal perioperative care for geriatric patients described in the literature.ResultsOur aim is to develop a feasible, safe, and effective protocol for geriatric patients undergoing elective craniotomy, which includes preoperative, intraoperative, and postoperative assessments and management, as well as outcome measures.ConclusionsThis multidisciplinary and evidence-based ERAS protocol has the potential to reduce perioperative morbidity, improve functional recovery, and enhance postoperative outcomes after cranial surgery in elderly. Further research will be necessary to establish strict guidelines.Copyright © 2024 Elsevier Inc. All rights reserved.

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