open access

Ahead of Print
Research paper
Published online: 2023-01-12
Get Citation

Effect of the implementation of an enhanced recovery after surgery protocol (ERAS) in patients undergoing an elective cesarean section

Maria Ofelia Sordia Pineyro1, Carlos Villegas-Cruz1, Magdalena Hernandez-Bazaldua1, Alfredo Pineyro-Cantu1, Tracy Gaston-Locsin1, Luis Humberto Sordia-Hernandez2
DOI: 10.5603/GP.a2023.003
Affiliations
  1. TEC Salud, Ignacio Morones Prieto, Monterrey, Mexico
  2. Department of Obstetrics, Hospital San José, Tec Salud, Monterrey, Nuevo Leon, Mexico, Mexico

open access

Ahead of Print
ORIGINAL PAPERS Obstetrics
Published online: 2023-01-12

Abstract

Objectives: To demonstrate that the application of an enhanced recovery after surgery (ERAS) protocol in elective cesarean sections is associated with reduced hospital stay without increasing maternal complications.

Material and methods: This retrospective, comparative study included patients who underwent an elective cesarean section. The patients were divided into groups: group 1, women who received elements of standardized care according to ERAS guidelines, and group 2, women who did not receive this care.

Results: The study included 295 patients, 139 in group 1 (ERAS) and 156 in group 2. The demographic characteristics were similar. Hospital stay and postoperative pain at 24 and 48 hours were lower in patients in group 1; these differences were statistically significant (p < 0.001). The overall complication rate, head pain, surgical wound infection, urinary retention, and readmission were similar in both groups.

Conclusions: The application of an ERAS protocol can reduce hospital stay and postoperative pain without increasing the postoperative complication rate in patients who undergo an elective cesarean section. In developing countries, the application of this protocol could help in optimizing available health system resources.

Abstract

Objectives: To demonstrate that the application of an enhanced recovery after surgery (ERAS) protocol in elective cesarean sections is associated with reduced hospital stay without increasing maternal complications.

Material and methods: This retrospective, comparative study included patients who underwent an elective cesarean section. The patients were divided into groups: group 1, women who received elements of standardized care according to ERAS guidelines, and group 2, women who did not receive this care.

Results: The study included 295 patients, 139 in group 1 (ERAS) and 156 in group 2. The demographic characteristics were similar. Hospital stay and postoperative pain at 24 and 48 hours were lower in patients in group 1; these differences were statistically significant (p < 0.001). The overall complication rate, head pain, surgical wound infection, urinary retention, and readmission were similar in both groups.

Conclusions: The application of an ERAS protocol can reduce hospital stay and postoperative pain without increasing the postoperative complication rate in patients who undergo an elective cesarean section. In developing countries, the application of this protocol could help in optimizing available health system resources.

Get Citation

Keywords

ERAS; enhanced recovery; enhanced recovery after surgery; c-section; cesarean section

About this article
Title

Effect of the implementation of an enhanced recovery after surgery protocol (ERAS) in patients undergoing an elective cesarean section

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2023-01-12

Page views

15

Article views/downloads

5

DOI

10.5603/GP.a2023.003

Keywords

ERAS
enhanced recovery
enhanced recovery after surgery
c-section
cesarean section

Authors

Maria Ofelia Sordia Pineyro
Carlos Villegas-Cruz
Magdalena Hernandez-Bazaldua
Alfredo Pineyro-Cantu
Tracy Gaston-Locsin
Luis Humberto Sordia-Hernandez

References (17)
  1. Maskey S, Bajracharya M, Bhandari S. Prevalence of cesarean section and its indications in a tertiary care hospital. JNMA J Nepal Med Assoc. 2019; 57(216): 70–73.
  2. Dahlke JD, Mendez-Figueroa H, Rouse DJ, et al. Evidence-based surgery for cesarean delivery: an updated systematic review. Am J Obstet Gynecol. 2013; 209(4): 294–306.
  3. Suárez L, Campero L, de la Vara E, Rivera L, Hernández M, Walker D, et al. High recurrence of cesarean sections: reversing the trend and improving the quality of delivery. National Health and Nutrition Survey 2012. Mexico City: National Institute of Public Health. 2012.
  4. van Ham MA, van Dongen PW, Mulder J. Maternal consequences of caesarean section. A retrospective study of intra-operative and postoperative maternal complications of caesarean section during a 10-year period. Eur J Obstet Gynecol Reprod Biol. 1997; 74(1): 1–6.
  5. Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: a review. JAMA Surg. 2017; 152(3): 292–298.
  6. Slim K, Delaunay L, Joris J, et al. Le Groupe francophone de réhabilitation améliorée après chirurgie (GRACE). How to implement an enhanced recovery program? Proposals from the Francophone Group for enhanced recovery after surgery (GRACE). J Visc Surg. 2016; 153(6S): S45–S49.
  7. Wrench IJ, Allison A, Galimberti A, et al. Introduction of enhanced recovery for elective caesarean section enabling next day discharge: a tertiary centre experience. Int J Obstet Anesth. 2015; 24(2): 124–130.
  8. Senturk JC, Kristo G, Gold J, et al. The development of enhanced recovery after surgery across surgical specialties. J Laparoendosc Adv Surg Tech A. 2017; 27(9): 863–870.
  9. Ban KA, Berian JR, Ko CY. Does implementation of Enhanced Recovery After Surgery (ERAS) protocols in colorectal surgery improve patient outcomes? Clin Colon Rectal Surg. 2019; 32(2): 109–113.
  10. Tanious MK, Ljungqvist O, Urman RD. Enhanced recovery after surgery: history, evolution, guidelines, and future directions. Int Anesthesiol Clin. 2017; 55(4): 1–11.
  11. Nelson G, Altman AD, Nick A, et al. Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations--Part I. Gynecol Oncol. 2016; 140(2): 313–322.
  12. Macones GA, Caughey AB, Wood SL, et al. Guidelines for postoperative care in cesarean delivery: Enhanced Recovery After Surgery (ERAS) society recommendations (part 3). Obstetric Anesthesia Digest. 2020; 40(2): 69–70.
  13. Caughey AB, Wood SL, Macones GA, et al. Guidelines for intraoperative care in cesarean delivery: Enhanced Recovery After Surgery society recommendations (part 2). Am J Obstet Gynecol. 2018; 219(6): 533–544.
  14. Gustafsson UO, Hausel J, Thorell A, et al. Enhanced Recovery After Surgery Study Group. Adherence to the enhanced recovery after surgery protocol and outcomes after colorectal cancer surgery. Arch Surg. 2011; 146(5): 571–577.
  15. ERAS Compliance Group. The Impact of Enhanced Recovery Protocol Compliance on Elective Colorectal Cancer Resection: Results From an International Registry. Ann Surg. 2015; 261(6): 1153–1159.
  16. Fay EE, Hitti JE, Delgado CM, et al. An enhanced recovery after surgery pathway for cesarean delivery decreases hospital stay and cost. Am J Obstet Gynecol. 2019; 221(4): 349.e1–349.e9.
  17. Rhou YJJ, Pather S, Loadsman JA, et al. Direct hospital costs of total laparoscopic hysterectomy compared with fast-track open hysterectomy at a tertiary hospital: a retrospective case-controlled study. Aust N Z J Obstet Gynaecol. 2015; 55(6): 584–587.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl