Preoperative fasting and maternal discomfort in women undergoing elective cesarean section Cesarean Section, Preoperative Fasting, Carbohydrate Loading, Preoperative Anxiety, Time to First Flatus, ERAS
Conditions
Interventions
100% apple juice 300 mL administered orally 2 hours before scheduled elective cesarean section under spinal anesthesia,Participants are required to fast from all food and fluids from midnight (00:00)
Experimental Dietary Supplement,Active Comparator No treatment
Preoperative oral carbohydrate loading with apple juice,Overnight fasting
Sponsors
Chaloem Phrakiat Rayong Hospital
Eligibility
Sex/Gender
Female
Age
18 Years to 40 Years
Inclusion criteria
Inclusion criteria: 1. Singleton pregnancy 2. Term pregnancy with gestational age 37 weeks or more 3. Scheduled for elective cesarean section 4. Undergoing spinal anesthesia 5. ASA physical status I to II 6. Able to communicate and assess the Visual Analog Scale VAS 7. Willing to participate and provide written informed consent
Exclusion criteria
Exclusion criteria: 1. Active labor 2. History of psychiatric disorders affecting anxiety assessment, such as anxiety disorder or panic disorder 3. Conditions affecting gastric emptying, including pregestational diabetes mellitus, gestational diabetes mellitus, or symptomatic gastroesophageal reflux disease 4. Body mass index 40 kg/m2 or more 5. Contraindications to spinal anesthesia, including coagulopathy, thrombocytopenia, local infection at needle site, or raised intracranial pressure 6. History of allergy to apple juice or fructose 7. Severe obstetric complications, including severe preeclampsia, eclampsia, or placenta accreta spectrum with anticipated massive hemorrhage 8. Major intraoperative complications, including postpartum hemorrhage with estimated blood loss 1,000 mL or more, bowel injury, or bladder injury 9. Use of opioid analgesics before surgery 10. Conversion from spinal anesthesia to general anesthesia during surgery 11. Inability to comply with fasting or apple juice protocol 12. Refusal or withdrawal of informed consent during the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Preoperative anxiety Upon arrival in the operative room, approximately 30 minutes before surgery Visual analog scale 0-10: 0 defined no anxiety and 10 defined worst anxiety | — |
Secondary
| Measure | Time frame |
|---|---|
| Hunger Upon arrival in the operative room, approximately 30 minutes before surgery Visual analog scale 0-10: 0 defined no hunger and 10 defined worst hunger,Thirst Upon arrival in the operative room, approximately 30 minutes before surgery Visual analog scale: 0-10: 0 defined no thirst and 10 defined worst thirst,Intraoperative nausea/vomiting During intraoperative period Direct observation by anesthesia nurse,Time to first flatus Time from end of surgery to first passage of flatus Self-report by patient,Patient satisfaction Prior to discharge Visual analog scale 0-10: 0 defined worst satisfaction and 10 defined best satisfaction | — |
Countries
Thailand
Contacts
Public ContactPasu Tuangjarwinai
Chaloem Phrakiat Rayong Hospital
Outcome results
None listed