Commonly used anesthesia-related components of enhanced recovery protocols for cesarean delivery^[1-4]

Minimize fasting; encourage clear liquids up to 2 hours before surgery

Suggest preoperative oral carbohydrate loading

Use neuraxial anesthesia

Administer antibiotic prophylaxis

Initiate multimodal analgesia based on long acting neuraxial opioid

Administer prophylaxis for intraoperative and postoperative nausea and vomiting

Maintain normothermia (eg, warm the OR, warm IV fluids, use forced air warming)

Optimize IV fluid administration, aiming for euvolemia

Promote early skin to skin contact, mother and neonate

ERAC protocols typically consist of institution-specific standardized multidisciplinary best practices for the peripartum period.
This table shows some of the commonly used anesthesia-related ERAC practices. Optimal components of ERAC protocols have not been established.

OR: operating room; IV: intravenous; ERAC: enhanced recovery after cesarean.

References:

Bollag L, Lim G, Sultan P, et al. Society for Obstetric Anesthesia and Perinatology: Consensus Statement and Recommendations for Enhanced Recovery After Cesarean. Anesth Analg 2020.
Wilson RD, Caughey AB, Wood SL, et al. Guidelines for Antenatal and Preoperative care in Cesarean Delivery: Enhanced Recovery After Surgery Society Recommendations (Part 1). Am J Obstet Gynecol 2018; 219:523.e1.
Caughey AB, Wood SL, Macones GA, et al. Guidelines for intraoperative care in cesarean delivery: Enhanced Recovery After Surgery Society Recommendations (Part 2). Am J Obstet Gynecol 2018; 219:533.
Sultan P, Sharawi N, Blake L, Carvalho B. Enhanced recovery after caesarean delivery versus standard care studies: a systematic review of interventions and outcomes. Int J Obstet Anesth 2020; 43:72.

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خرید پکیج

Commonly used anesthesia-related components of enhanced recovery protocols for cesarean delivery[1-4]

Commonly used anesthesia-related components of enhanced recovery protocols for cesarean delivery^[1-4]