Clinical Research Of ERAS Anesthesia Strategy In The Perioperative Of Cesarean Section

Objective:To evaluate the efficacy of enhanced recovery after surgery（ERAS）anesthesia strategy in the perioperative of cesarean section.Methods:One hundred puerperae,aged 22～45 years old,of American Society of Anesthesiologists physical statusⅡ,singletons,body mass index（BMI）≤35 kg/m²,gestational age 37～42 weeks,scheduled for elective cesarean section in 2020 were selected and divided into either the ERAS group（group E）or the conventional perioperative management group（group C）by random number table method,with 50patients in each group.All puerperae were treated with combined spinal-epidural anesthesia,which was performed in the L_3-4 space,0.5%ropivacaine hydrochloride2.5～3ml was injected into the subarachnoid.Perioperative management of group E:preoperative ERAS education was carried out,the time of preoperative fasting was shortened.Intraoperative warming,restrictive fluid therapy,multi-mode antiemetic measures and the intradermal suture with absorbable line were carried out during operation.Multi-mode analgesic measures,early intake of water and food through the mouth,shorten the time of catheter indwelling,and get out of bed as soon as possible after operation.In group C,the traditional concept was adopted for perioperative management.Demographic characteristics,perioperative information,the visual analogue scale（VAS）scores at the rest and exercise 6,12,and 24 hours after operation,the dosage of opioid and the requirement for rescue analgesia within 24hours after operation,the first flatus time,the first postoperative off-bed time,the postoperative length of hospital stay,the occurrence of adverse reactions such as nausea and vomiting,infection of incision and urinary retention after operation,and the score of maternal satisfaction were recorded.Results:1.A total of 100 parturient women were included in this study and all completed the experiment.There was no significant difference in age,BMI,gestational age,history of cesarean section,the case of gestational hypertension and gestational diabetes between the two groups（P>0.05）.2.There was no significant difference in bleeding volume,surgery time,the occurrence of intraoperative hypotension,neonatal weight,the Apgar score of newborns and whether transferred into NICU（P>0.05）.Compared with group C,the occurrence of intraoperative shivering was reduced in group E（P<0.05）.3.Compared with group C,the VAS scores at the rest and exercise 6 hour after operation were reduced,the dosage of opioid within 24 hours after operation was reduced in group E（P<0.05）,no puerpera required rescue analgesia after operation in two groups.4.Compared with group C,the first flatus time,the first postoperative off-bed time and the postoperative length of hospital stay were shortened in group E（P<0.05）.5.Compared with group C,the incidence of postoperative nausea and vomiting was reduced in group E（P<0.05）.No urinary retention or incision infection were observed after operation in two groups.6.Compared with group C,the perioperative satisfaction was improved ingroup E（P<0.05）.Conclusion:ERAS anesthesia strategy could reduce the dosage of opioid analgesics after surgery,shorten the time of first flatus,first postoperative off-bed and the postoperative length of hospital stay,reduce the incidence of postoperative nausea and vomiting,and improve maternal satisfaction in perioperative management of cesarean section in puerperae,is safely and effectively.