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A randomized controlled trial of enhanced recovery after surgery vs standard of care recovery for emergency cesarean deliveries at Mbarara Hospital, Uganda

Anesthesia & Analgesia Mar 01, 2020

Baluku M, et al. - To determine the benefit of implementing the enhanced recovery after surgery (ERAS) protocols for emergency cesarean deliveries in a low-resource setting, researchers performed this prospective, randomized, single-blind, controlled trial in Uganda, involving mothers delivering by emergency cesarean delivery. The participants were randomly allocated to either an ERAS or a standard of care recovery arm. A modified ERAS protocol was applied in the ERAS arm. This modified protocol incorporated modified counseling and education, prophylactic antibiotics, antiemetics, normothermia, restrictive fluid administration, and multimodal analgesia. Patients in the ERAS arm also got early initiation of mobilization, feeding, and urethral catheter removal. Enrolled patients were 160 in total, with 80 randomized to each arm. Findings revealed the feasibility of the application of an ERAS protocol for women undergoing emergency cesarean delivery in a low-income setting. The use of an ERAS protocol in this population provided decreased length of hospital stay without generally raising the complication rate.
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