SYSTEMATIC REVIEW TENTANG PERBEDAAN PASIEN SECTION CAESAREAN DENGAN PROTOKOL ERAS DAN TANPA PROTOKOL ERAS
Keywords:
Caesarean ERAS, efficacy, maternal external, pain management, length of stay, hospital stay cost
Abstract
ERAS method, which is originally intended for colorectal patients, has been recently adopted into obstetrics and extensively studied in the Caesarean Section surgery. However, it is believed that the effectiveness of ERAS for Caesarean Section is quite poor. There is also lack of literature especially on improving mother’s recovery. The purpose of this systematic review is to evaluate Caesarean Section patients with ERAS Protocol and without ERAS Protocol in relation to length of stay, hospital stay cost, and postoperative pain scale. This systematic review was carried out by searching for studies containing in the database or search engine accessed through Pubmed, Clinical Key, Google Scholar, Research Gate, and Science Direct from 2016 to 2021 using Indonesian and English. Out of 225 studies, only 11 studies fulfilled the inclusion criteria. They were divided into 8 cohort studies and 3 RCT studies. There were three findings revealed. First, 78% studies reported that length of stay was reduced in ERAS group. Second, 100% studies had the link with hospital stay cost reduction in ERAS group. Third, 100% studies disclosed reduced postoperative pain scale in ERAS group. Based on the findings, it can be concluded that there was a significant difference between ERAS group and conventional service group in terms of length of stay, hospital stay cost, and postoperative pain scale.
References
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Baluku, M., Bajunirwe, F., Ngonzi, J., Kiwanuka, J., & Ttendo, S. (2020). A Randomized Controlled Trial of Enhanced Recovery After Surgery Versus Standard of Care Recovery for Emergency Cesarean Deliveries at Mbarara Hospital, Uganda. Anesthesia and Analgesia, 130(3):769-776. https://doi.org/10.1213/ANE.0000000000004495
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Corso, E., Hind, D., Beever, D., Fuller, G., Wilson, M., & Wrench, I. J. (2017). Enhanced recovery after elective caesarean: a rapid review of clinical protocols, and an umbrella review of systematic reviews. BMC Pregnancy Childbirth, 17(1):91. https://doi.org/10.1186/s12884-017-1265-0
Eisenach, James., Pan, Peter., Smiley, Richard., Lavand'homme, Patricia., Landau, R., & Houle, T. T. (2008). Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain, 140(1):87-94. https://doi.org/10.1016/j.pain.2008.07.011
Fay, E. E., Hitti, J. E., Delgado, C. M., Savitsky, L. M., Mills, E. B., & Slater, J. L. (2019) An enhanced recovery after surgery pathway for cesarean delivery decreases hospital stay and cost. Am J Obstet Gynecol, 221:349. https://doi.org/10.1016/j.ajog.2019.06.041
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Kalogera, E., & Dowdy, S. C. (2016). Enhanced Recovery Pathway in Gynecologic Surgery: Improving Outcomes Through Evidence-Based Medicine. Obstetrics and Gynecology Clinics of North America, 43(3):551-573. https://doi.org/10.1016/j.ogc.2016.04.006
Kehlet, Henrik. (2015). Enhanced Recovery After Surgery (ERAS): good for now, but what about the future? Can J Anaesth, 62(2):99-104. https://doi.org/10.1007/s12630-014-0261-3
Kleiman, A. M., Chisholm, C. A., Dixon, A. J., Sariosek, B. M., Thiele, R. H., Hedrick, T. L., Carvalho, B., & Tiouririne, M. (2020). Evaluation of the impact of enhanced recovery after surgery protocol implementation on maternal outcomes following elective cesarean delivery. International Journal of Obstetric Anesthesia, 43:39-46. https://doi.org/10.1016/j.ijoa.2019.08.004
Konlan, K. D., Baku, E. K., Japiong, M., Dodam Konlan, K., & Amoah, R. M. (2019). Reasons for Women’s Choice of Elective Caesarian Section in Duayaw Nkwanta Hospital. Journal of Pregnancy, 2019:1-7. https://doi.org/10.1155/2019/2320743
Laronche, A., Popescu, L., & Benhamou, D. (2017). An enhanced recovery programme after caesarean delivery increases maternal satisfaction and improves maternal-neonatal bonding: A case control study. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 210:212-216. https://doi.org/10.1016/j.ejogrb.2016.12.034
Lester, S. A., Kim, B., Tubinis, M. D., Morgan, C. J., & Powell, M. F. (2020). Impact of an enhanced recovery program for cesarean delivery on postoperative opioid use. International Journal of Obstetric Anesthesia, 43:47-55. https://doi.org/10.1016/j.ijoa.2020.01.005
Li, L., Jin, J., Min, S., Liu, D., & Liu, L. (2017). Compliance with the enhanced recovery after surgery protocol and prognosis after colorectal cancer surgery: A prospective cohort study. Oncotarget, 8(32):53531-53541. https://doi.org/10.18632/oncotarget.18602
Lockwood, C., & Oh, E. G. (2017). Systematic reviews: Guidelines, tools and checklists for authors. Nursing and Health Sciences, 19(3):273-277. https://doi.org/10.1111/nhs.12353
Martin, J. A., Hamilton, B. E., Osterman, M., Driscoll, A. K., & Drake, P. (2018). Births: Final Data for 2016. National vital statistics reports: from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, 67(1):1-55.
Mullman, L., Hilden, P., Goral, J., Gwacham, N., Tauro, C., Spinola, K., Rosales, K., Collier, S., Holmes, L., Maccione, J., Pitera, R., Miller, R., & Yodice, P. (2020). Improved Outcomes with an Enhanced Recovery Approach to Cesarean Delivery. Obstetrics and Gynecology, 136(4):685-691. https://doi.org/10.1097/AOG.0000000000004023
Pan, J., Hei, Z., Li, L., Zhu, D., Hou, H., Wu, H., Gong, C., & Zhou, S. (2020). The Advantage of Implementation of Enhanced Recovery After Surgery (ERAS) in Acute Pain Management During Elective Cesarean Delivery: A Prospective Randomized Controlled Trial. Therapeutics and Clinical Risk Management, 16:369-378. https://doi.org/10.2147/TCRM.S244039
Prior, E., Santhakumaran, S., Gale, C., Philipps, L. H., Modi, N., & Hyde, M. J. (2012). Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature. The American Journal of Clinical Nutrition, 95(5):1113-1135. https://doi.org/10.3945/ajcn.111.030254
Shinnick, J. K., Ruhotina, M., Has, P., Kelly, B. J., Brousseau, E. C., O'Brien, J., & Peahl, A. F. (2021). Enhanced Recovery after Surgery for Cesarean Delivery Decreases Length of Hospital Stay and Opioid Consumption: A Quality Improvement Initiative. American Journal of Perinatology, 38(S 01):e215-e223. https://doi.org/10.1055/s-0040-1709456
Stone, A. B., Wick, E. C., Wu, C. L., & Grant, M. C. (2017). The US Opioid Crisis: A Role for Enhanced Recovery After Surgery. Anesthesia and Analgesia, 125(5):1803-1805. https://doi.org/10.1213/ANE.0000000000002236
Sultan, P., Sharawi, N., Blake, L., & Carvalho, B. (2021). Enhanced recovery after caesarean delivery versus standard care studies: a systematic review of interventions and outcomes. International Journal of Obstetric Anesthesia, 43:72-86. https://doi.org/10.1016/j.ijoa.2020.03.003
Tamang, T., Wangchuk, T., Zangmo, C., Wangmo, T., & Tshomo, K. (2021). The successful implementation of the Enhanced Recovery After Surgery (ERAS) program among caesarean deliveries in Bhutan to reduce the postoperative length of hospital stay. BMC pregnancy and childbirth, 21(1):637. https://doi.org/10.1186/s12884-021-04105-9
Teigen, N. C., Sahasrabudhe, N., Doulaveris, G., Xie, X., Negassa, A., Bernstein, J., & Bernstein, P. S. (2020). Enhanced recovery after surgery at cesarean delivery to reduce postoperative length of stay: a randomized controlled trial. American journal of obstetrics and gynecology, 222(4), 372.e1–372.e10. https://doi.org/10.1016/j.ajog.2019.10.009
Wilson, R. D., Caughey, A. B., Wood, S. L., Macones, G. A., Wrench, I. J., Huang, J., Norman, M., Pettersson, K., Fawcett, W. J., Shalabi, M. M., Metcalfe, A., Gramlich, L., & Nelson, G. (2018). Guidelines for Antenatal and Preoperative care in Cesarean Delivery: Enhanced Recovery After Surgery Society Recommendations (Part 1). American journal of obstetrics and gynecology, 219(6), 523.e1–523.e15. https://doi.org/10.1016/j.ajog.2018.09.015
Wu, C. L., Rowlingson, A. J., Partin, A. W., Kalish, M. A., Courpas, G. E., Walsh, P. C., & Fleisher, L. A. (2005). Correlation of postoperative pain to quality of recovery in the immediate postoperative period. Regional anesthesia and pain medicine, 30(6), 516–522. https://doi.org/10.1016/j.rapm.2005.07.190
American Society of Anesthesiologists Task Force on Acute Pain Management (2012). Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology, 116(2):248-273. https://doi.org/10.1097/ALN.0b013e31823c1030
Asamoah, B. O., Moussa, K. M., Stafström, M., & Geofrey, M. (2011). Distribution of causes of maternal mortality among different socioeconomic status. BMC Public Health, 11:159. https://doi.org/10.1186/1471-2458-11-159
Baluku, M., Bajunirwe, F., Ngonzi, J., Kiwanuka, J., & Ttendo, S. (2020). A Randomized Controlled Trial of Enhanced Recovery After Surgery Versus Standard of Care Recovery for Emergency Cesarean Deliveries at Mbarara Hospital, Uganda. Anesthesia and Analgesia, 130(3):769-776. https://doi.org/10.1213/ANE.0000000000004495
Bowden, S. J., Dooley, W., Hanrahan, J., Kanu, C., Halder, S., Cormack, C., O'Dwyer, S., & Singh, N. (2019). Fast-track pathway for elective caesarean section: a quality improvement initiative to promote day 1 discharge. BMJ Open Quality, 8(2):e000465. https://doi.org/10.1136/bmjoq-2018-000465
Corso, E., Hind, D., Beever, D., Fuller, G., Wilson, M., & Wrench, I. J. (2017). Enhanced recovery after elective caesarean: a rapid review of clinical protocols, and an umbrella review of systematic reviews. BMC Pregnancy Childbirth, 17(1):91. https://doi.org/10.1186/s12884-017-1265-0
Eisenach, James., Pan, Peter., Smiley, Richard., Lavand'homme, Patricia., Landau, R., & Houle, T. T. (2008). Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain, 140(1):87-94. https://doi.org/10.1016/j.pain.2008.07.011
Fay, E. E., Hitti, J. E., Delgado, C. M., Savitsky, L. M., Mills, E. B., & Slater, J. L. (2019) An enhanced recovery after surgery pathway for cesarean delivery decreases hospital stay and cost. Am J Obstet Gynecol, 221:349. https://doi.org/10.1016/j.ajog.2019.06.041
Halder, S., Onwere, C., Brennan, C., Singh, N., Cox, M., & Yentis, S. M. (2014). Enhanced recovery programme for elective caesarean section. Arch Dis Child Fetal Neonatal Ed 99:A19.
Hedderson, M., Lee, D., Hunt, E., Lee, K., Xu, F., Mustille, A., Galin, J., Campbell, C., Quesenberry, C., Reyes, V., Huang, M., Nicol, B., Paulson, S., & Liu, V. (2019). Enhanced Recovery After Surgery to Change Process Measures and Reduce Opioid Use After Cesarean Delivery: A Quality Improvement Initiative. Obstetrics and Gynecology, 134(3):511-519. https://doi.org/10.1097/AOG.0000000000003406
Kalogera, E., & Dowdy, S. C. (2016). Enhanced Recovery Pathway in Gynecologic Surgery: Improving Outcomes Through Evidence-Based Medicine. Obstetrics and Gynecology Clinics of North America, 43(3):551-573. https://doi.org/10.1016/j.ogc.2016.04.006
Kehlet, Henrik. (2015). Enhanced Recovery After Surgery (ERAS): good for now, but what about the future? Can J Anaesth, 62(2):99-104. https://doi.org/10.1007/s12630-014-0261-3
Kleiman, A. M., Chisholm, C. A., Dixon, A. J., Sariosek, B. M., Thiele, R. H., Hedrick, T. L., Carvalho, B., & Tiouririne, M. (2020). Evaluation of the impact of enhanced recovery after surgery protocol implementation on maternal outcomes following elective cesarean delivery. International Journal of Obstetric Anesthesia, 43:39-46. https://doi.org/10.1016/j.ijoa.2019.08.004
Konlan, K. D., Baku, E. K., Japiong, M., Dodam Konlan, K., & Amoah, R. M. (2019). Reasons for Women’s Choice of Elective Caesarian Section in Duayaw Nkwanta Hospital. Journal of Pregnancy, 2019:1-7. https://doi.org/10.1155/2019/2320743
Laronche, A., Popescu, L., & Benhamou, D. (2017). An enhanced recovery programme after caesarean delivery increases maternal satisfaction and improves maternal-neonatal bonding: A case control study. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 210:212-216. https://doi.org/10.1016/j.ejogrb.2016.12.034
Lester, S. A., Kim, B., Tubinis, M. D., Morgan, C. J., & Powell, M. F. (2020). Impact of an enhanced recovery program for cesarean delivery on postoperative opioid use. International Journal of Obstetric Anesthesia, 43:47-55. https://doi.org/10.1016/j.ijoa.2020.01.005
Li, L., Jin, J., Min, S., Liu, D., & Liu, L. (2017). Compliance with the enhanced recovery after surgery protocol and prognosis after colorectal cancer surgery: A prospective cohort study. Oncotarget, 8(32):53531-53541. https://doi.org/10.18632/oncotarget.18602
Lockwood, C., & Oh, E. G. (2017). Systematic reviews: Guidelines, tools and checklists for authors. Nursing and Health Sciences, 19(3):273-277. https://doi.org/10.1111/nhs.12353
Martin, J. A., Hamilton, B. E., Osterman, M., Driscoll, A. K., & Drake, P. (2018). Births: Final Data for 2016. National vital statistics reports: from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, 67(1):1-55.
Mullman, L., Hilden, P., Goral, J., Gwacham, N., Tauro, C., Spinola, K., Rosales, K., Collier, S., Holmes, L., Maccione, J., Pitera, R., Miller, R., & Yodice, P. (2020). Improved Outcomes with an Enhanced Recovery Approach to Cesarean Delivery. Obstetrics and Gynecology, 136(4):685-691. https://doi.org/10.1097/AOG.0000000000004023
Pan, J., Hei, Z., Li, L., Zhu, D., Hou, H., Wu, H., Gong, C., & Zhou, S. (2020). The Advantage of Implementation of Enhanced Recovery After Surgery (ERAS) in Acute Pain Management During Elective Cesarean Delivery: A Prospective Randomized Controlled Trial. Therapeutics and Clinical Risk Management, 16:369-378. https://doi.org/10.2147/TCRM.S244039
Prior, E., Santhakumaran, S., Gale, C., Philipps, L. H., Modi, N., & Hyde, M. J. (2012). Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature. The American Journal of Clinical Nutrition, 95(5):1113-1135. https://doi.org/10.3945/ajcn.111.030254
Shinnick, J. K., Ruhotina, M., Has, P., Kelly, B. J., Brousseau, E. C., O'Brien, J., & Peahl, A. F. (2021). Enhanced Recovery after Surgery for Cesarean Delivery Decreases Length of Hospital Stay and Opioid Consumption: A Quality Improvement Initiative. American Journal of Perinatology, 38(S 01):e215-e223. https://doi.org/10.1055/s-0040-1709456
Stone, A. B., Wick, E. C., Wu, C. L., & Grant, M. C. (2017). The US Opioid Crisis: A Role for Enhanced Recovery After Surgery. Anesthesia and Analgesia, 125(5):1803-1805. https://doi.org/10.1213/ANE.0000000000002236
Sultan, P., Sharawi, N., Blake, L., & Carvalho, B. (2021). Enhanced recovery after caesarean delivery versus standard care studies: a systematic review of interventions and outcomes. International Journal of Obstetric Anesthesia, 43:72-86. https://doi.org/10.1016/j.ijoa.2020.03.003
Tamang, T., Wangchuk, T., Zangmo, C., Wangmo, T., & Tshomo, K. (2021). The successful implementation of the Enhanced Recovery After Surgery (ERAS) program among caesarean deliveries in Bhutan to reduce the postoperative length of hospital stay. BMC pregnancy and childbirth, 21(1):637. https://doi.org/10.1186/s12884-021-04105-9
Teigen, N. C., Sahasrabudhe, N., Doulaveris, G., Xie, X., Negassa, A., Bernstein, J., & Bernstein, P. S. (2020). Enhanced recovery after surgery at cesarean delivery to reduce postoperative length of stay: a randomized controlled trial. American journal of obstetrics and gynecology, 222(4), 372.e1–372.e10. https://doi.org/10.1016/j.ajog.2019.10.009
Wilson, R. D., Caughey, A. B., Wood, S. L., Macones, G. A., Wrench, I. J., Huang, J., Norman, M., Pettersson, K., Fawcett, W. J., Shalabi, M. M., Metcalfe, A., Gramlich, L., & Nelson, G. (2018). Guidelines for Antenatal and Preoperative care in Cesarean Delivery: Enhanced Recovery After Surgery Society Recommendations (Part 1). American journal of obstetrics and gynecology, 219(6), 523.e1–523.e15. https://doi.org/10.1016/j.ajog.2018.09.015
Wu, C. L., Rowlingson, A. J., Partin, A. W., Kalish, M. A., Courpas, G. E., Walsh, P. C., & Fleisher, L. A. (2005). Correlation of postoperative pain to quality of recovery in the immediate postoperative period. Regional anesthesia and pain medicine, 30(6), 516–522. https://doi.org/10.1016/j.rapm.2005.07.190
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