Assessment of Enhanced Recovery Protocols in Elective Cesarean Sections

Abstract

Background: One of the procedures that is carried out the most frequently globally is the Caesarean section (CS). The introduction of enhanced recovery (ER) for planned CS to enable earlier discharge is receiving a lot of interest. The aim of this study was to assess the  enhanced recovery protocols versus the standard care in elective cesarean section and to introduce enhanced recovery protocols to  Zagazig University maternity hospitals and Al-Ahrar Teaching Hospital to decrease hospital stays and opioid use.

Methods: This non- randomized controlled trial included patients attending  Zagazig University Hospitals and Al-Ahrar Teaching Hospital for elective caesarean sections in the period between September 2018 and August 2019. The number of patients included in the study was 96  patients classified into two groups. A general clinical examination, laboratory investigations, and radiological studies were done. A  Cesarean section for all patients of both groups was performed.

Results: Regarding the opiates used during the process of recovery for  pain control in both groups, the overall mean of both groups was 0.25 ± 0.342 amp. and 1.156 ± 0.463 amp. in group (a) and group (b)  respectively, where there was a significant statistical difference between the two groups.

Conclusions: When enhanced recovery after  surgery (ERAS) protocols are used in elective cesarean sections, patients treated with these protocols benefit from earlier ambulation,  earlier resumption of intestinal sounds, earlier oral intake tolerated, decreased catheterization time, decreased amounts of opiates used  and their obvious side effects, an improved satisfaction score, and decreased pain.