Implementation of Early Recovery After Caesarean Surgery Protocol in Floating Hospital (Case Series)

IF 0.2 Q4 PHARMACOLOGY & PHARMACY
Akhyar Nur Uhud, B. Welantika, Senda Sulvain, T. Y. Aden
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Abstract

Introduction: Enhanced Recovery After Caesarean Surgery (ERACS) is a new concept that combines various evidence-based perioperative care to reduce post-operative complications and accelerate patient recovery after Caesarean Surgery (C-Section). The advantages of the ERACS Protocol, including accelerating patients' recoveries, shortening hospital stays, and reducing post-operative complications, make it suitable to be applied in floating hospitals. The problem is whether this protocol can be applied if it is carried out in a floating hospital with all its limitations. We would like to present our case series with modified ERACS protocol in Floating Hospital Ksatria Airlangga. Case Presentation: We present 4 patients scheduled for elective C-Section. Neuraxial opioids with low-dose morphine, the most frequently used technique in ERACS, were not administered due to its unavailability in Ksatria Airlangga Floating Hospital. We provide pre-emptive analgesia and multimodal analgesia to obtain adequate perioperative analgesia. All patients were admitted to the nearest public health centre for post-operative observation and discharged after 1 to 2 days. Satisfaction was achieved in all patients without any significant postoperative complications. Conclusion: The ERACS protocols’ main goal can be achieved even under limited conditions, but several adjustments are required according to the available resources.
漂浮医院剖宫产术后早期康复方案的实施(病例系列)
剖宫产术后增强恢复(Enhanced Recovery After Caesarean Surgery, ERACS)是一种结合各种循证围手术期护理的新概念,旨在减少剖宫产术后并发症,加速患者恢复。ERACS方案具有加速患者康复、缩短住院时间、减少术后并发症等优点,适合在浮动医院推广应用。问题是,如果在具有所有局限性的流动医院执行该协议,是否可以适用。我们想介绍我们在Ksatria Airlangga浮动医院采用修改后的ERACS方案的病例系列。病例介绍:我们报告了4例计划择期剖腹产的患者。由于Ksatria Airlangga流动医院无法提供低剂量吗啡,因此没有使用ERACS中最常用的低剂量吗啡的轴向阿片类药物。我们提供了先发制人的镇痛和多模式的镇痛,以获得足够的围手术期镇痛。所有患者均在最近的公共卫生中心接受术后观察,1 ~ 2天后出院。所有患者均满意,无明显术后并发症。结论:在有限的条件下,ERACS协议的主要目标是可以实现的,但需要根据现有资源进行一些调整。
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