Introduction of enhanced recovery for elective caesarean section enabling next day discharge: a tertiary centre experience

International Journal of Obstetric Anesthesia
I J WrenchM J Wilson

Abstract

The widespread adoption of enhanced recovery programmes in various surgical specialties has resulted in patient benefits including reduced morbidity, reduced length of stay and an earlier return to normal activities. This evidence, along with the increased financial pressures in the UK National Health Service, has led many units to consider introducing such a programme for obstetric surgery. We report our experience in setting up an enhanced recovery programme for women undergoing elective caesarean section and a prospective analysis of factors that influence length of stay. An enhanced recovery pathway was designed by a multidisciplinary team and introduced in March 2012. Factors influencing length of stay were determined using a log normal model. The proportion of women discharged on Day 1 increased from 1.6% in the first quarter of 2012 to 25.2% in the first quarter of 2014. The 30-day readmission rate was 4.4% for those discharged on Day 1 and 5.6% for Day 2. Earlier gestation, multiple birth, intention to breast feed, longer surgery and more time in the post-anaesthesia recovery unit were all independently associated with a longer postoperative stay. Women presenting for obstetric surgery with the indication "one previous ...Continue Reading

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Citations

Jul 6, 2016·International Journal of Obstetric Anesthesia·E CoatesT Stephens
Aug 10, 2016·Surgery Research and Practice·Dario BugadaGuido Fanelli
May 18, 2018·F1000Research·Unyime Ituk, Ashraf S Habib
Sep 13, 2019·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Sajidah IlyasSohail Bampoe
Jul 6, 2016·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Aykan YucelDilek Uygur
May 3, 2018·Frontiers in Medicine·Borislava PujicCurtis L Baysinger
Feb 19, 2020·Current Opinion in Obstetrics & Gynecology·Sanaa Suharwardy, Brendan Carvalho
Sep 27, 2020·Acta Obstetricia Et Gynecologica Scandinavica·Anne R KruseUlrik S Kesmodel
Nov 13, 2020·Acta Obstetricia Et Gynecologica Scandinavica·Anne R KruseIben B Sundtoft
Feb 12, 2020·International Journal of Obstetric Anesthesia·S A LesterM F Powell
Mar 9, 2021·Current Anesthesiology Reports·Kishan Patel, Mark Zakowski
Apr 5, 2017·Gynécologie, Obstétrique, Fertilité & Sénologie·A CattinE Raimond

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