Ambulation, Cross-sectional study, Cesarean delivery, Enhanced recovery after surgery
Citation Information :
Vipulachandra Y, Narkhede H, Bhanap PL, Karale A, Chavan RB. Enhanced Recovery after Surgery Protocol Implementation on Elective Cesarean Delivery: A Cross-sectional Study. J South Asian Feder Obs Gynae 2022; 14 (6):667-671.
Aim and objective: To estimate the outcomes of enhanced recovery after surgery (ERAS) protocol implementation in perioperative elective cesarean patients.
Study design: Cross-sectional study was conducted from January 2020 to December 2021 at a tertiary healthcare center. During the study period, ERAS protocol was implemented on elective cesarean deliveries at the study institution to find out the time to first ambulate, incidence of urinary retention, total intravenous (IV) fluids in the postoperative period, tolerability of early oral intake, hospital stay, readmissions for maternal cause, and the complications up to 30 days postpartum.
Results: In total, 150 cases were enrolled in the study. Six hours 23 minutes was the mean ambulation time, and all patients started ambulation within 10 hours of surgery. There were no cases of urinary retention. About 132 patients needed 1500 mL of IV fluids in the postopertive period. About 146 postoperative patients tolerated a 2-hour liquid diet. The postoperative length of stay was 3 days 3 hours with 11 cases of postoperative complications with 3 cases requiring readmission.
Conclusion: The implementation of ERAS protocols in elective cesarean delivery has shown favorable outcomes with minimal complications and readmission. Early resumption of oral feed was well-tolerated and led to a reduced need for IV fluids. Early removal of the catheter aided in early ambulation and without undue retention of urine. Early discharge is beneficial for the patient to reduce hospital-acquired infections and bed turnover in limited-bedded hospitals. Enhanced recovery after surgery protocol can be implemented in low-risk elective cases posted for cesarean delivery in Government hospitals.
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