Evaluating ERAS Protocol Implementation for Elective Caesarean Delivery: A Pilot Study on Perioperative Outcomes

Introduction: The global rise in Caesarean Section (CS) rates has spotlighted the need to optimise perioperative care to enhance maternal recovery and reduce postoperative complications. Traditional perioperative practices, such as prolonged fasting, delayed mobilisation, and opioid-based analgesia, often contribute to suboptimal recovery and extended hospital stays. Enhanced Recovery After Surgery (ERAS) protocols offer a structured, evidence-based alternative aimed at minimising surgical stress, reducing opioid consumption, and accelerating recovery. Aim: To assess the effectiveness of the ERAS protocol in improving postoperative recovery outcomes in patients undergoing elective CS. Materials and Methods: This pilot study, designed as a prospective interventional, single-blind investigation, was conducted by the Department of Obstetrics and Gynaecology at Jawaharlal Nehru Medical College (JNMC), Wardha,Maharashtra, India. from January 2022 to December 2024. A total of 208 women undergoing elective CS were randomised into two equal groups: ERAS and traditional care. The ERAS group received comprehensive preoperative education, multimodal non opioid analgesia, early oral intake, and early ambulation, while the traditional group received conventional perioperative care. Key outcomes assessed included postoperative pain scores, opioid use, incidence of ileus, and duration of hospital stay. Statistical analysis included the Chi-square test for categorical variables, with p<0.05 considered significant. Results: Baseline demographic and clinical characteristics were comparable between the groups. The mean age of participants was 27.08±4.54 years. Patients managed under ERAS reported significantly lower pain scores (VAS 6/10 in 73.21%), complete avoidance of opioids (0% vs. 87.08%), and no cases of postoperative ileus. Moreover, all ERAS patients were discharged within five days, compared to 7-10 days in the traditional group (p<0.001 for all comparisons). Conclusion: The implementation of ERAS protocols in elective CS significantly improves postoperative recovery by reducing pain, eliminating opioid dependency, enhancing gastrointestinal function, and shortening hospital stays. These findings support the broader adoption of ERAS as a standard of care in obstetric surgery.