Enhancing Perioperative Recovery in Gestational Diabetes: Assessing the Effectiveness of an Enhanced Recovery after Surgery Protocol for Cesarean Section.

Abstract

This study evaluated the effectiveness of implementing an Enhanced Recovery after Surgery (ERAS) protocol in enhancing recovery outcomes following cesarean section (CS) in 200 women with gestational diabetes mellitus (GDM). The patients were randomized into an ERAS group or a Control group. The ERAS protocol differed from routine care by reducing preoperative fasting times, using targeted medications, employing neuraxial anesthesia and warming measures, initiating early feeding and mobilization, goal-directed fluid management, and earlier catheter removal to enhance recovery and minimize complications. Various outcome measures, including postoperative length of hospital stay (LOS) and time to achieve postoperative milestones, were assessed. Postoperative pain relief was evaluated using the visual analogue scale (VAS), while quality of life was assessed through the EuroQoL (EQ-5D-5L) survey. Patient satisfaction with nursing care was determined using the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ). The ERAS group demonstrated significantly shorter postoperative LOS and achieved recovery milestones faster than the Control group. Postoperative pain relief outcomes were significantly improved in the ERAS group, with lower VAS scores for pain during rest and breastfeeding compared to the Control group. The ERAS protocol also effectively improved specific health dimensions and overall QOL following CS in patients with GDM. Furthermore, the ERAS group exhibited higher levels of patient satisfaction with postpartum nursing care quality compared to the Control group. Implementation of an ERAS protocol in CS for women with GDM significantly enhances postoperative recovery outcomes, including shorter hospital stay, improved pain relief, enhanced QOL, and increased patient satisfaction.