Compare Outcome of Enhanced Recovery After Cesarean Surgery and Conventional Care

Compare Outcome of Enhanced Recovery After Cesarean Surgery and Conventional Care in Rajavithi Hospital

Research objective to compare outcome(Length of stay, pain score, opioid drug use, Bowel function and complication ) of ERAS protocol and conventional care in pregnant women after elective cesarean section in Rajavithi hospital.

Research design is Randomized control trial. The pregnant women who go to elective cesarean section don't know the allocation. The group of ERAS protocol was separated from Conventional care in patient care unit.

The Pregnant are randomly in two group. In the ERAS group the pregnant receive the the intervention for preoperative care(Counselin, H2- antagonist and metroclopramide for prevent aspiration, Drink clear liquid until 2 hour before surgery), Intraoperative care (first generation cephalosporin in 60 minute before surgery, Clorhexidine for skin cleansing and Povidine for vaginal cleansing, regional anesthesia, keep warming, blunt expansion of uterine incision, do not peritoneal suture and subcuticular suture if less than 2 cm, local wound anesthesia.), post operative care ( Paracetamol and NSAIDs for for pain control, early remove catheter and ambulation, 5-HT3 antagonist for prevent nausea)

Inclusion Criteria:

• Pregnant women who scheduled for elective Cesarean section at Rajavithi Hospital

Exclusion Criteria:

• Pregnant women who has preeclampsia with severe feature
• Pregnant women who has diabetes mellitus with uncontrolled blood sugar
• Pregnant women who has blood loss > 1,500 ml after surgery
• Pregnant women who has chrioamnionitis.
• Pregnant women who has severe medical disease
• Pregnant women who has BMI >= 40 kg/m2
• Pregnant women who has placenta adherence.