Patel Kishan, Zakowski Mark
Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Blvd #8211, Los Angeles, CA 90048 USA.
Curr Anesthesiol Rep. 2021;11(2):136-144. doi: 10.1007/s40140-021-00442-9. Epub 2021 Mar 2.
What are the latest enhanced recovery elements for cesarean delivery?
Enhanced recovery after cesarean delivery (ERAC) provides an evidenced-based system to improve maternal outcomes, functional recovery, maternal-infant bonding, and patient experience. Postsurgical recovery has evolved from a one-dimensional pain score to a holistic multidimensional approach emphasizing faster functional recovery. ERAC involves multidisciplinary efforts of the anesthesiologist, obstetrician, nursing, hospital, and patient. Components of ERAC include preoperative patient education, limited fasting, carbohydrate load, limiting opioids intra- and postoperatively, using scheduled non-opioid analgesics and supplementing with advanced therapies for women at higher risk for pain. ERAC protocols reduce opioid consumption, reduce length of stay, and improve maternal and neonatal outcomes.
Implementing ERAC standardized care will likely be the most important change you can make in your practice to improve outcomes, improve quality care, help address racial disparities, and minimize opioid exposure and potential for addiction.
剖宫产最新的加速康复要素有哪些？
剖宫产术后加速康复（ERAC）提供了一个基于证据的系统，以改善产妇结局、功能恢复、母婴情感联结和患者体验。术后恢复已从单一维度的疼痛评分发展为强调更快功能恢复的整体多维度方法。ERAC涉及麻醉医生、产科医生、护理人员、医院和患者的多学科协作。ERAC的组成部分包括术前患者教育、缩短禁食时间、碳水化合物负荷、限制术中和术后阿片类药物的使用、使用定时非阿片类镇痛药以及为疼痛风险较高的女性补充先进疗法。ERAC方案可减少阿片类药物的使用、缩短住院时间，并改善母婴结局。
实施ERAC标准化护理可能是你在实践中可以做出的最重要的改变，以改善结局、提高护理质量、帮助解决种族差异，并最大限度地减少阿片类药物暴露和成瘾可能性。
