Pan Jingru, Hei Ziqing, Li Liping, Zhu Dan, Hou Hongying, Wu Huizhen, Gong Chulian, Zhou Shaoli
Department of Anesthesiology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
Department of Obstetrics, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
Ther Clin Risk Manag. 2020 May 4;16:369-378. doi: 10.2147/TCRM.S244039. eCollection 2020.
The aim of this study was to test whether the implementation of an enhanced recovery after surgery (ERAS) protocol for patients undergoing elective cesarean delivery has a positive impact on the postoperative status of the patients in terms of pain management, hospital stay, hospitalization costs, and adverse reactions.
Patients who underwent elective cesarean delivery were randomized into two groups - ERAS group and control group - and the groups were managed with the ERAS protocol and traditional protocol, respectively.
Compared to the control group, the ERAS group had significantly fewer patients with intraoperative nausea, pain of visual analog scale (VAS) scores, and VAS grade >3 during rest in the first 24 h and during motion in the first 24 and 48 h after surgery. There were no intergroup differences in the requirement of extra analgesics, the incidence of vomiting, shivering, hypotension, postoperative nausea, and pruritus. None of the patients in either group had postoperative vomiting. Patient satisfaction rated as per the VAS was significantly higher in the ERAS group than in the control group. The total length of stay, postoperative length of stay, and the cost of anesthesia in both groups were comparable. Further, the average daily hospitalization cost was significantly lower in the ERAS group than in the control group.
The ERAS protocol shows promise and appears to be worthwhile for widespread implementation among patients undergoing elective cesarean delivery; it was found to be beneficial in reducing the postoperative pain, incidence of intraoperative nausea, and average cost of hospitalization and also improved patient satisfaction.
本研究旨在测试对择期剖宫产患者实施加速康复外科（ERAS）方案是否会在疼痛管理、住院时间、住院费用及不良反应方面对患者术后状况产生积极影响。
将接受择期剖宫产的患者随机分为两组——ERAS组和对照组，分别采用ERAS方案和传统方案进行管理。
与对照组相比，ERAS组术中恶心、术后24小时内静息时视觉模拟评分（VAS）疼痛及术后24小时和48小时内活动时VAS分级>3的患者明显更少。两组在额外镇痛药需求、呕吐、寒战、低血压、术后恶心及瘙痒发生率方面无组间差异。两组均无患者出现术后呕吐。根据VAS评定的患者满意度，ERAS组显著高于对照组。两组的总住院时间、术后住院时间及麻醉费用相当。此外，ERAS组的日均住院费用显著低于对照组。
ERAS方案显示出前景，似乎值得在择期剖宫产患者中广泛实施；该方案被发现有利于减轻术后疼痛、术中恶心发生率及平均住院费用，还提高了患者满意度。
