Enhanced Recovery after Caesarian Section, Madagascar

Abstract

Introduction: Few hospital practice enhanced recovery after caesarian section. Our aims is to evaluate the application of enhanced recovery after caesarian section after implementation in our service.
 Materials and Methods : An observational audit prospective was conducted, from November 2018 to January 2019, in the complex mother-child Military Hospital, Antsiranana. Patients between 18 to 35 years, ASA 1 or 2 before surgery were included. General anesthesia procedures are excluded.
 Results: Thirty-one patients were identified. Each received antiotic prophylaxis and prevention of postoperative nausea/ vomiting and intratechal morphine. Fluid infusion was optimized in 18 patients. In post-interventional recovery room, multimodal analgesia were given orally after the intervention in 15 patients (48%), Sixteen (52%) cases drunk. Forty-four patients (45%) ate food four hour after intervention. Stop infusion performed in 13 cases (42%). The bladder catheter removed in 13 patients (42%). The median length of stay was 3.5 days.
 Conclusion : Early food, removal of the bladder catheter and the infusion stop have low compliance to the protocol. An audit and formation were needed.