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Amira Farag Nagib Easa, Khaled Hassan Ahmed Swidan, Ihab Adel Gomaa Ali, Ebtihal Mohamed Mahmoud Eltaieb, Enhanced Recovery after Elective Cesarean Delivery at Ain Shams University Maternity Hospital: A Randomized Controlled Trial, QJM: An International Journal of Medicine, Volume 117, Issue Supplement_2, October 2024, hcae175.579, https://doi.org/10.1093/qjmed/hcae175.579
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Abstract
Enhanced recovery after cesarean delivery (ERAC) is perioperative care program to fasten patients recovery. ERAC protocols intended to improve patient outcomes and fasten return to normal function before surgery by standardization of practice at all stages: preoperative, intraoperative and postoperative.
The aim of this study was to evaluate whether the implementation of enhanced recovery after cesarean (ERAC) would decrease the length of hospital stay and pain score and improve postoperative patient satisfaction and breastfeeding and its effect on postoperative complications and hospital readmission.
86 pregnant women undergoing uncomplicated elective cesarean delivery were enrolled in this study. patients were randomized to two groups: 43 patients in the Enhanced recovery after cesarean delivery (ERAC) group and 43 patients in the standard care group. Enhanced recovery after cesarean involved multiple evidence-based interventions and were divided into the three major phases of patient care: antepartum, intrapartum and postpartum. The primary outcome was the length of hospital stay after cesarean delivery. Secondary outcomes included pain medication requirements and pain scores, breastfeeding and first time of start breastfeeding, maternal satisfaction, postoperative complications and hospital readmission.
Enhanced recovery after cesarean delivery was associated with a highly significantly shorter length of hospital stay when compared to standard care (p- value <0.001). There was a highly significant reduction in pain scores at 2h, 4h, 6h and 12h in the ERAC group in comparison to standard care group (p-value <0.001). There was no statistically significant difference between the two groups of studied participants regarding breastfeeding (p-value=0.5). However, there was statistically highly significant difference between the two groups of studied participants regarding the time of starting breastfeeding (p-value <0.001). The participants were more significantly satisfied in the ERAC group than in the standard group (p-value>0.001).
Implementation of enhanced recovery after elective cesarean delivery (ERAC) pathway lead to significantly shorter length of hospital stay, lower pain scores, better patient satisfaction and earlier start of breastfeeding.
- client satisfaction
- pregnancy
- analgesics
- postoperative complications
- breast feeding
- cesarean section
- hospitals, maternity
- intraoperative care
- length of stay
- mothers
- patient readmission
- perioperative care
- preoperative care
- postpartum period
- surgical procedures, operative
- surgery specialty
- elective cesarean delivery
- evidence-based practice
- pain score
- standard of care
- patient-focused outcomes
- primary outcome measure
- enhanced recovery after surgery