A comparative study of enhanced recovery after surgery (ERAS) versus non enhanced recovery after surgery (Non-ERAS) pathway for caesarean deliveries

Abstract

Enhanced recovery is to optimize multiple aspects of patient care to improve recovery thereby facilitating earlier discharge, without a reduction in patient satisfaction or the quality of care. Currently, there are limited randomized studies exist in the literature specifically addressing the potential impact of an enhanced recovery pathway among women undergoing caesarean delivery on postoperative outcomes and postoperative length of stay. The study was done to determine efficacy of ERAS in comparison with Standard care among caesarean deliveries in perioperative care outcome i.e. length of hospital stay, complications. This is a Prospective Randomized Control study was conducted on the subjects who were undergoing scheduled caesarean Delivery at a tertiary care centre from August 2020 to September 2020. A total of 80 study subjects, 40 in each group by randomization were allocated into Group A (ERAS group) and Group B (Standard of Care group). All the study subjects in both the groups received pre-operative prophylaxis like antibiotic administration 30 min prior to surgery, Administration of anaesthesia, and post & intraoperative nausea vomiting (PONV/IONV) prophylaxis, DVT prophylaxis. Whereas active warming during section was given to subjects who were in ERAS Group only. In the study there was significant difference in Median duration of IV infusion, Oral intake for liquids & for solids, catheter removal, first ambulation after CS and duration of hospital stay between two groups. All the above parameters were delayed in Non-ERAS group compared to ERAS group. To conclude that ERAS is the way to promote maternal and neonatal healthcare through proper utilization of protocols and guidelines. Implementation of ERAS programmes along with continuous performance reports will help in improved delivery care of the both the mother and child.

Initiation of an Enhanced Recovery After Cesarean Delivery Protocol in a University Hospital in Serbia: A randomized comparison with existing management

“…Patients in the ERAS group were encouraged to begin oral fluid intake upon arrival in the PACU, as contrasted with the control group, who first allowed oral intake 6 hours after PACU arrival. Junaidi et al 23 showed that early oral intake had no effect on PONV, but did promote earlier postoperative bowel function; spontaneous bowel empting was also significantly earlier in ERAS group in our series.…”

Implementing Enhanced Recovery after Surgery in Obstetrics: A Lesson from the Nationwide Lockdown

“…13 Similar outcomes were reported from India. 14 Focused and modified ERAS RCT by Madhumala et al has clearly demonstrated the benefit of early gut stimulation and postoperative nausea and vomiting although the end point of shorter postoperative hospital stay was not analyzed. 15 Early feeding as a focused postoperative component of ERAS in Pakistan showed favorable maternal outcomes.…”

Quality improvement initiative to address bed shortage in the maternity ward at the National Referral Hospital

“…Despite the challenges, modified ERAS has also proven beneficial in limited‐resource settings. Only a few care flow processes in preoperative, intraoperative, or postoperative pathways were implemented based on the resources available 7–9 . These studies in low resource settings have clearly demonstrated the benefits in terms of early hospital discharge, lesser postoperative complications, readmission, and greater patient satisfaction.…”