Objective To explore the clinical application value of modified and optimized enhanced recovery after surgery (ERAS) management in the perioperative period of patients undergoing robot-assisted laparoscopic radical prostatectomy (RLRP).

Methods A total of 100 RLRP patients were selected as the research subjects and randomly divided into conventional group (receiving conventional ERAS management) and research group (receiving modified and optimized ERAS management) using the random number table method, with 50 cases in each group. Perioperative indicators, the use of anesthetic drugs, and the levels of physiological stress indicatorscortisol (Cor), norepinephrine (NE), plasma renin activity (PRA)and coagulation function indicatorsprothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT) before and after surgery were compared between the two groups. The incidence of postoperative complications and the readmission rate within 30 days after surgery were also statistically analyzed.

Results The intraoperative fluid infusion volume in the research group was less than that in the conventional group. The postoperative time to get out of bed, time to first flatus, pelvic drainage tube retention time, and hospital stay in the research group were horter than those in the conventional group (P < 0.05). The incidence of intraoperative hypothermia in the research group was lower than that in the conventional group, with statistically significant differences (P < 0.05). The doses of propofol and cisatracurium in the research group were less than those in the conventional group, with statistically significant differences (P < 0.05). After surgery, the levels of Cor, NE and PRA in both groups were higher than those before surgery, but they were lower in the research group than those in the conventional group, with statistically significant differences (P < 0.05). After surgery, the TT, PT and APTT in both groups were longer than those before surgery, but they were shorter in the research group than those in the conventional group, with statistically significant differences (P < 0.05). The overall incidence of complications in the research group was lower than that in the conventional group, with a statistically significant difference (P < 0.05). There was no statistically significant difference in the readmission rate within 30 days after surgery between the two groups (P>0.05).

Conclusion Modified and optimized ERAS management can effectively promote rapid postoperative recovery in RLRP patients, reduce the doses of anesthetic drugs and fluid infusion volume, alleviate physiological stress responses, improve the body's coagulation function, and reduce the risk of complications.