Enhanced recovery after surgery (ERAS) protocols accelerate recovery in elderly patients undergoing emergency surgery for perforated peptic ulcers.

• ERAS patients achieved bowel movement in 1.21 days vs. 2.20 days (p=0.008) and mobilized faster (1.26 vs. 3.51 days, p<0.001).
• Hospital stays were significantly shorter: 5.24 days vs. 7.03 days (p=0.001).

Implementing ERAS led to better pain control, lower opioid use (8.49 mg vs. 18.73 mg, p=0.001), and reduced nausea (22.4% vs. 41.8%, p=0.013) without increasing complications.

These findings support ERAS as a safe option for enhancing recovery in older emergency surgery patients, but results may vary for frailer individuals.