选择性剖宫产术与传统剖宫产术相比,剖宫产术后恢复能力增强:一项前瞻性观察研究

IF 0.2 Q4 ANESTHESIOLOGY
Sunanda Gupta, Apoorva Gupta, Aditi Baghel, Karuna Sharma, S. Choudhary, Vidhu Choudhary
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引用次数: 4

摘要

背景:增强的康复方案在有效控制疼痛、缩短住院时间(LOS)和更早恢复正常活动方面降低了发病率。本研究旨在比较我院剖宫产术后增强恢复(Enhanced recovery after caesarean section, ERAC)方案与传统剖宫产(caesarean section, CS)护理方案。材料和方法:选择性CS患者接受ERAC方案(A组;n = 100)前6个月和传统方案(B组;N = 100),在接下来的六个月。主要结果是住院总时间(出院准备)的比较,而次要目标是术中血流动力学控制和血管加压剂的需求,视觉模拟量表(VAS)评分和24小时内镇痛药需求的比较,ERAC组件实施的障碍,尿潴留和再导管的需要以及围手术期的任何不良事件。结果:A组患者LOS或出院准备率显著降低;B组为2.85±0.5 vs 5.25±0.61 (p < 0.0001)。A组术后VAS评分明显低于b组(p < 0.0001),且24 h内抢救镇痛药的使用明显减少。(p < 0.001) ERAC方案的组成部分成功实施,术后活动时间、脱导管时间和恢复口服喂养时间均有显著差异。结论:实施ERAC可显著降低剖宫产术后LOS发生率,减轻疼痛,减少术后阿片类药物需求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Enhanced recovery after cesarean protocol versus traditional protocol in elective cesarean section: A prospective observational study
Background: Enhanced recovery programs result in reduced morbidity in terms of effective pain control, reduced length of stay (LOS), and an earlier return to normal activities. This study has been conducted to compare Enhanced recovery after caesarean (ERAC) protocol to traditional care of cesarean section (CS) in our institute. Materials and Methods: Patients undergoing elective CS were subjected to ERAC protocol (Group A; n = 100) for first six months and traditional protocol (Group B; n = 100) for next six months. Primary outcome was comparison of total duration of stay (readiness to discharge) in the hospital, whereas secondary objectives were intraoperative hemodynamic control and requirement of vasopressor, comparison of Visual Analogue Scale (VAS) scores and requirement of analgesics in 24 hrs, barriers to implementation of ERAC components, urinary retention and need of recatheterization and any adverse events perioperatively. Results: Significant reduction in LOS or readiness for discharge was found in Group A; 2.85 ± 0.5 vs 5.25 ± 0.61 hrs in Group B (p < 0.0001). Episodes of hypotension and requirement of phenylephrine was significantly more in Group B. (p < 0.0001) VAS scores in Group A were significantly less postoperatively with significant reduction in consumption of rescue analgesic in 24 hrs. (p < 0.001) Components of ERAC protocol were implemented successfully with significant difference in time of ambulation, decatheterization, and resumption of oral feed postoperatively. Conclusion: Implementation of ERAC results in significant reduction in LOS in hospital with better pain relief and reduced postoperative opioid requirement following cesarean delivery.
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