Rajendran Sankarnarayanan, Karigar Shivanand L, Kori Shreedevi, Alalamath Santosh, D Pratibha S
Department of Anesthesiology, Shri BM Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura, IND.
Department of Obstetrics and Gynecology, Shri BM Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura, IND.
Cureus. 2025 Apr 12;17(4):e82129. doi: 10.7759/cureus.82129. eCollection 2025 Apr.
Background Cesarean delivery is a significant milestone in a mother's life, often marked by joy. However, the postoperative period can be physically challenging, especially for those undergoing the procedure due to maternal or fetal indications. Objectives This study aimed to evaluate the effectiveness of a tailored enhanced recovery after surgery (ERAS) protocol in managing acute pain following elective cesarean deliveries. Traditional protocols often prolong maternal discomfort and delay recovery. Methods Eligible patients who provided written informed consent were randomized into two groups: the ERAS protocol (EP) group and the routine protocol (RP) group. Both groups underwent comprehensive preanesthetic evaluations, including history-taking, systemic examination, airway assessment, and standard blood investigations. Patients in the EP group were allowed to consume clear fluids up to two hours before surgery, whereas those in the RP group adhered to the conventional six-hour fasting protocol. Results Each group included 50 patients. Intraoperative shivering was significantly lower in the EP group (22.7%; five patients) compared to the RP group (77.3%; 17 patients) (p < 0.005). Hypotension occurred in 10 EP patients versus 32 in the RP group (p < 0.005). At 24 hours post-surgery, pain scores measured using the Visual Analogue Scale were significantly lower in the EP group both at rest (1.76 ± 0.82 vs. 2.96 ± 0.95) and during movement (2.46 ± 0.81 vs. 3.78 ± 0.89) (p < 0.005 for both). Opioid use was also markedly reduced in the EP group, with only two patients (4%) requiring opioids postoperatively, compared to 25 patients (50%) in the RP group (p < 0.005). Conclusions The tailored ERAS protocol significantly improved acute postoperative pain management in cesarean deliveries. Patients in the ERAS group experienced fewer intraoperative complications, reduced opioid consumption, faster mobilization, shorter hospital stays, and higher overall satisfaction.
剖宫产是母亲生命中的一个重要里程碑，通常伴随着喜悦。然而，术后恢复期对身体来说可能具有挑战性，尤其是对于那些因母体或胎儿指征而接受该手术的人。
本研究旨在评估一种量身定制的术后加速康复（ERAS）方案在择期剖宫产后管理急性疼痛方面的有效性。传统方案常常会延长产妇的不适并延迟恢复。
符合条件并提供书面知情同意书的患者被随机分为两组：ERAS方案（EP）组和常规方案（RP）组。两组均接受全面的麻醉前评估，包括病史采集、系统检查、气道评估和标准血液检查。EP组患者在手术前两小时可饮用清亮液体，而RP组患者则遵循传统的六小时禁食方案。
每组各有50名患者。与RP组（77.3%；17例患者）相比，EP组术中寒战发生率显著更低（22.7%；5例患者）（p<0.005）。EP组有10例患者发生低血压，而RP组有32例（p<0.005）。术后24小时，使用视觉模拟量表测量的疼痛评分在EP组静息时（1.76±0.82对2.96±0.95）和活动时（2.46±0.81对3.78±0.89）均显著更低（两者p均<0.005）。EP组的阿片类药物使用也明显减少，术后只有2例患者（4%）需要使用阿片类药物，而RP组有25例患者（50%）（p<0.005）。
量身定制的ERAS方案显著改善了剖宫产术后的急性疼痛管理。ERAS组患者术中并发症更少，阿片类药物消耗减少，活动更快，住院时间更短，总体满意度更高。
