Keywords
Elective surgery
Enhanced recovery after surgery
Patient satisfaction
How to Cite
Abstract
Background: Enhanced Recovery After Surgery (ERAS) is a multimodal patient centred perioperative care pathway aimed at accelerating patient recovery, improving patient satisfaction, decreasing length of hospital stay, and post-operative complications.
Objectives: To assess patient satisfaction with ERAS protocol in the most common surgical procedure in the world, elective Caesarean Section.
Methods: A descriptive cross-sectional study was carried out in the department of Obstetrics and Gynaecology at Kathmandu Medical College Teaching Hospital (KMCTH) from July 2020 to February 2021 after ethical approval. The study included all pregnant ladies undergoing elective Caesarean section under ERAS protocol by convenient sampling and their satisfaction with the treatment received was recorded using a pre-validated questionnaire at the time of discharge. Data was analysed using SPSS.
Results: A total of 140 patients were enrolled in the study. Majority of the patients considered the introduction of feeding (100, 71.4%) and ambulation (115, 82.1%) to be on time. Seventy-three patients (52.1%) considered themselves fit for discharge on the second post-operative day and 70 (50%) were discharged on the second post-operative day itself which is earlier compared to the hospital protocol of discharge on the third or fifth post-operative day. Most of the women (136, 97.1%) were satisfied with the care they received and 132 (94.3%) of them would prefer to undergo surgery under the ERAS protocol in the future.
Conclusion: Most women were satisfied with the surgical experience and would prefer to undergo surgery under the same protocol in the future.
References
Pilkington L, Curpad S, Parveen S. Enhanced recovery after surgery (ERAS) in obstetrics in Royal Gwent Hospital. Eur J Obstet Gynecol. 2016 Nov 1;206:e92. [Full Text | DOI]
Adamina M, Kehlet H, Tomlinson GA, Senagore AJ, Delaney CP. Enhanced recovery pathways optimise health outcomes and resource utilisation: A metaanalysis of randomised controlled trials in colorectal surgery. Surgery. 2011 Jun;149(6):830-40. [PubMed | Full Text | DOI]
Patel K, Zakowski M. Enhanced recovery after Caesarean: Current and emerging trends. Curr Anesthesiol Rep. 2021 Mar 2;11(2):136-44. [PubMed |Full Text]
Prasad A, Bhandari G, Saha R. Profile of Caesarean section at Kathmandu Medical College. J Nepal Health Res Counc. 2017 Sep 15;15(2):110-3. [PubMed | Full Text]
Wilson RD, Caughey AB, Wood SL, Macones GA, Wrench IJ, Huang J, et al. Guidelines for antenatal and preoperative care in Caesarean delivery: Enhanced recovery after surgery society recommendations (Part 1). Am J Obstet Gynecol. 2018 Dec 1;219(6):523- e1. [PubMed | Full Text]
Caughey AB, Wood SL, Macones GA, Wrench IJ, Huang J, Norman M, et al. Guidelines for intraoperative care in Caesarean delivery: Enhanced recovery after surgery society recommendations (part 2). Am J Obstet Gynecol. 2018 Dec 1;219(6):533- 44. [PubMed | Full Text]
Teigen NC, Sahasrabudhe N, Doulaveris G, Xie X, Negassa A, Bernstein J et al . Enhanced recovery after surgery at Caesarean delivery to reduce postoperative length of stay: A randomised controlled trial. Am J Obstet Gynecol. 2020 Apr 1;222(4):372.e1-372.e10. [PubMed | Full Text | DOI]
Macones GA, Caughey AB, Wood SL, Wrench IJ, Huang J, Norman M, et al. Guidelines for postoperative care in Caesarean delivery: Enhanced Recovery After Surgery (ERAS) Society recommendations (part 3). Am J Obstet Gynecol. 2019 Sep 1;221(3):247-e1. [PubMed | Full Text]
Ituk U, Habib AS. Enhanced recovery after Caesarean delivery. F1000Research. 2018;7. [Full Text]
Cherot E. ERAS: Improved outcomes post-Caesarean. Contemp Ob/Gyn. 2018 Jul 1;63(7):21-2. [Full Text]
Olivares C, M, Labalde Martínez M, Torralba M, Rodríguez Fraile JR, Atance Martínez JC. Satisfaction survey after an ERAS (Enhanced Recovery After Surgery) protocol in colorectal elective surgery in patients over 70 years of age. Rev Colomb de Anestesiol. 2018 Sep;46(3):187-95. [Full Text]
Thiele RH, Rea KM, Turrentine FE, Friel CM, Hassinger TE, McMurry TL, et al. Standardisation of care: Impact of an enhanced recovery protocol on length of stay, complications, and direct costs after colorectal surgery. J Am Coll Surg. 2015 Apr 1;220(4):430-43. [PubMed | Full Text]
Partoune A, Coimbra C, Brichant JF, Joris J. Quality of life at home and satisfaction of patients after enhanced recovery protocol for colorectal surgery. Acta Chir Belg. 2017 May 4;117(3):176-80. [PubMed | Full Text]
Khan S, Wilson T, Ahmed J, Owais A, MacFie J. Quality of life and patient satisfaction with enhanced recovery protocols. Colorectal Dis. 2010 Dec;12(12):1175-82. [PubMed | Full Text | DOI]
Pan J, Hei Z, Li L et al. The advantage of implementation of Enhanced Recovery After Surgery (ERAS) in acute pain management during elective Caesarean delivery: A prospective randomised controlled trial. Ther Clin Risk Manag. 2020;16:369-78. [PubMed | Full Text]
Li D, Jensen CC. Patient satisfaction and quality of life with enhanced recovery protocols. Clin Colon Rectal Surg. 2019 Mar;32(2):138-44. [PubMed | Full Text]