Cesarean Delivery
Conditions
Keywords
cesarean delivery, ERAS protocol
Brief summary
This study is designed to help us with ERAS (Enhanced Recovery After Surgery) Protocol for Cesarean Delivery implementation with goal to improve patient satisfaction and decrease length of stay at hospital. This will improve patient treatment and decrease total hospital costs.
Detailed description
ERAS assumes cooperation between obstetricians, anesthesiologists and parturient. This is the new concept because patient have an active role in the whole process. Pregnant patient receives the first information about ERAS from obstetrician and anesthesiologist before the scheduled cesarean delivery. Patient condition optimization is necessary. Antibiotic prophylaxis, no bowel preparation and arriving to the hospital on the day of surgery are basic principles. All patients are done under spinal anesthesia. DVT (Deep Venous Thrombosis) prophylaxis starts postoperatively. Early mobilization, early oral intake and urinary catheter removal on the day of surgery with multimodal analgesia is mandatory.
Interventions
COMBINATION_PRODUCTERAS protocol
No routine bowel preparation Antibiotics prophylaxis PONV (Postoperative Nausea and Vomiting) prophylaxis Spinal anesthesia Post- Cesarean analgesia (Acetaminophen 1g IV q6h, Tramadol 50mg IV q6h, Quadratus lumborum Block Oral pain relief medication Pain scores every day (VAS) Hospital length of stay Patient satisfaction
Sponsors
Pujic Borislava
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* All healthy patients from 18-45 years for scheduled Cesarean Delivery
Exclusion criteria
* Age younger then 18 years old and older then 45 years * Urgent and emergent Cesarean Delivery * Preeclampsia * Contraindications for spinal anesthesia * Abnormal placentation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Post-Cesarean pain scoring | Measured from postoperative day (PO) Day 0 to PO day 3 (72 hours) | Visual Analog Scale (VAS) for pain assessment (scale from 0-10). Score 0 to 5 is satisfactory pain control. Score 6 to 10 is not a good pain control and is necessary to add medication. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hospital length of stay | PO Day 0 until time of discharge PO Day 3-4 (72-96 hours) | Length of stay might influence on cost savings. Investigator expects discharge hospital will be on the PO day 3. |
| Post-partal depression development | Measured from the Cesarean Delivery to 6 weeks postoperatively | Inadequate postoperative treatment could cause chronic pain which could be the reason for post- partal depression development. Six weeks after delivery investigator will call mothers for interview and fill the Edinburgh Postnatal Depression Scale. Score 10 and more is suspect for depression risk. |
Countries
Serbia
Contacts
Primary ContactBorislava Pujic, PhD
Backup ContactLidija Jovanovic, MD
Outcome results
None listed