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Completed

NCT Number: NCT07104890

Enhanced Recovery After Surgery (ERAS) Protocol in Elective Cesarean Sections

This study evaluates the effect of the Enhanced Recovery After Surgery (ERAS) protocol on early postoperative recovery in women undergoing elective cesarean section.

Eighty-four pregnant women, aged 18 years or older, at 37 weeks of gestation or beyond, without chronic medical conditions, and classified as ASA I-II, were enrolled. Participants were randomly assigned to either:

ERAS group - received the ERAS protocol, including early oral intake, early mobilization, multimodal analgesia, and enhanced perioperative care

Control group - received standard perioperative cesarean section care

The study compared breastfeeding initiation time, gas passage, oral intake, mobilization time, and postoperative pain scores (VAS) between the two groups.

The aim is to determine whether ERAS can accelerate recovery, reduce pain, and improve maternal comfort after elective cesarean delivery.

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Key information

Conditions

Elective Cesarean Section Enhanced Recovery After Surgery (ERAS) Neurologic Manifestations Pain Pain, Postoperative Pathologic Processes Pathological Conditions, Signs and Symptoms Postoperative Complications Postoperative Recovery Signs and Symptoms

Age range

18 year and older

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Bartın City Hospital

Bartın, Turkey (Türkiye)

About this study

Enhanced Recovery After Surgery (ERAS) protocols aim to accelerate postoperative recovery, reduce complications, and shorten hospital stays. While ERAS has been widely implemented in general and gynecologic surgeries, its application in obstetric surgery, particularly elective cesarean delivery, remains limited.

This single-center, prospective, randomized clinical trial was conducted at the University of Health Sciences, Istanbul Gaziosmanpasa Training and Research Hospital, between October 2022 and December 2022. Eighty-four women scheduled for elective cesarean section were enrolled. Eligible participants were 18 years or older, at ≥37 weeks of gestation, ASA I-II, without chronic comorbidities, and provided written informed consent.

Participants were randomized (1:1) into two groups:

ERAS group: Managed with ERAS protocol including early oral intake, early mobilization, multimodal analgesia with opioid-sparing strategies, prophylactic antiemetics, early urinary catheter removal, and gum chewing to stimulate bowel function.

Control group: Managed with standard perioperative cesarean care including delayed oral intake, standard pain management, and later mobilization.

Primary outcomes included breastfeeding initiation time, gas passage, time to oral intake, mobilization time, and postoperative pain scores (VAS at 24 and 48 hours). Secondary outcomes included nausea-vomiting incidence and overall postoperative recovery profile.

The study aims to determine whether ERAS protocols improve postoperative recovery and patient comfort after elective cesarean section and to support the implementation of ERAS as a standard in obstetric surgery.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Pregnant women aged 18 years or older

Gestational age ≥37 weeks

Classified as ASA I or ASA II

Scheduled for elective cesarean section under spinal anesthesia

Able and willing to provide informed consent

No chronic systemic diseases

Exclusion criteria

Age <18 years

Gestational age <37 weeks

Emergency cesarean delivery

ASA III or higher

Presence of obstetric complications (e.g., preeclampsia, placenta previa, placental abruption, fetal distress)

Chronic comorbidities (e.g., diabetes, hypertension, cardiac or pulmonary disease)

Declines spinal anesthesia or unable to provide consent

Treatment and study plan

Enhanced Recovery After Surgery (ERAS) Protocol, which includes early oral intake, early mobilization, opioid-sparing multimodal analgesia, prophylactic antiemetics, early urinary catheter removal, an

Behavioral

The Enhanced Recovery After Surgery (ERAS) Protocol for elective cesarean section includes a multimodal perioperative care approach aimed at accelerating postoperative recovery. Key components are early oral intake, early mobilization, opioid-sparing multimodal analgesia, prophylactic antiemetics, early removal of the urinary catheter, and gum chewing to stimulate bowel function. This protocol is compared with Standard Perioperative Cesarean Care, which involves overnight fasting, delayed oral intake until bowel function returns, conventional analgesia, later mobilization, and routine catheter removal.

Primary outcomes

  1. Time to First Mobilization After Cesarean Section

    Time frame: Within 24 hours postoperatively

    Time from the end of elective cesarean section surgery to the patient's first ambulation, measured in hours. Early mobilization reflects enhanced postoperative recovery and is a key indicator of the ERAS protocol's effectiveness.

Secondary outcomes

  1. Incidence of Postoperative Nausea and Vomiting

    Time frame: Within 48 hours postoperatively

    Assessment of the presence and duration of postoperative nausea and vomiting (PONV) following elective cesarean section. Nausea and vomiting episodes will be recorded and analyzed to compare the incidence between the ERAS protocol group and the standard care group.

Sponsors and collaborators

Lead sponsor

Havva Betül Bacak

Other Gov

Registry information

Official study title

Evaluation of Enhanced Recovery After Surgery (ERAS) Protocol on Postoperative Recovery in Elective Cesarean Sections

Acronym: ERAS-CS

Important dates

Study start
2022
Primary completion
2022
Study completion
2022
First posted
Aug 5, 2025
Registry last updated
Aug 5, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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