Clinical Outcome in Patient Undergoing LSCS via ERAS Pathway versus Traditional Pathway: A Prospective Observational Study.

Abstract

ERAS is an evidence-based management protocol for perioperative care, to accelerate patient recovery. The field of obstetrics has been a late adapter of ERAS pathway for CS, and the literature is limited from Indian population. This prospective non-randomized comparative clinical study was conducted on 190 pregnant patients, out of which 95 were subjected to ERAS protocol (Group 1) and remaining 95 cases were enrolled in existing traditional protocol (Group 2). The primary objective was to compare quality of recovery based on obstetric-specific QoR 11 questionnaire between patients undergoing ERAC and traditional protocol for elective LSCS. Secondary objective was to compare perioperative bleeding, breast feeding initiation and difficulties, first oral intake, ambulation attempts, decatheterization, surgical site infection and length of hospital stay. At 24h postoperatively, mean QoR score was significantly higher for patients in the ERAC group (85.5 ± 7.46 vs 57.1 ± 11.33, p value < 0.01). In the ERAC group, 50.5% of the mothers started breastfeeding within first hour. The mean duration to start oral intake postoperatively was significantly lower in ERAC group. In the ERAC group, ambulation and decatheterization were attempted within 6h postoperatively in 86.3%. The mean length of hospital stay was significantly lower for patients in the ERAC group (68.8 ± 1.9 vs 105.4 ± 25.7h, p value < 0.001). The use of ERAC protocol at cesarean delivery significantly improves quality of recovery and length of hospital stay.