Varisara Chantarasorn1, Yuen Tannirandorn. 1. Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Rama IV Rd, Bangkok 10330, Thailand. varis@loxinfo.co.th
Abstract
OBJECTIVE: To compare the efficacy and side effects of early postoperative feeding versus conventional feeding for patients undergoing cesarean section. MATERIAL AND METHOD:Women undertaking uncomplicated cesarean section under regional anesthesia were randomly assigned to early feeding or conventional feeding groups. Early-fed women were offered a liquid diet within 8 hours after surgery, advanced to a soft diet on the next meal and then a regular diet. Conventional-fed women were prohibited from mouth-fed for the first 24 hours after surgery, advanced to a liquid diet on the first postoperative day, and then a soft diet on the second postoperative day. RESULTS:Two hundred patients were enrolled in the study; 107 patients were assigned to the early feeding group and 93 patients to theconventional feeding group. There were no significant differences in the demographic data between the two groups. In all cases, consistent anesthetic method was applied with no intraoperative adhesion and no post operative complications were observed. The rate of mild ileus symptoms in the early feeding group was significantly less than the conventional group (19.6% versus 31.1%, p = 0.03). The early feeding group also had significantly shorter time interval to bowel movement (16.7 hours versus 25.3 hours, p < 0.001), duration of intravenous fluid administration (20.5 hours versus 24.8 hours, p < 0.001), and overall length of hospital stays (3.3 days versus 4.0 days, p < 0.001). CONCLUSION: The study results indicated that the early feeding after uncomplicated cesarean section had reduced the rate of ileus symptoms and offer potential benefits associated with shorter interval to bowel movement, intravenous fluid administration, and length of hospital stays. However, management of postoperative feeding requires proper counseling on details of both regimens and flexibilities should be provided to accommodate early feeding when requested by the patients.
RCT Entities:
OBJECTIVE: To compare the efficacy and side effects of early postoperative feeding versus conventional feeding for patients undergoing cesarean section. MATERIAL AND METHOD:Women undertaking uncomplicated cesarean section under regional anesthesia were randomly assigned to early feeding or conventional feeding groups. Early-fed women were offered a liquid diet within 8 hours after surgery, advanced to a soft diet on the next meal and then a regular diet. Conventional-fed women were prohibited from mouth-fed for the first 24 hours after surgery, advanced to a liquid diet on the first postoperative day, and then a soft diet on the second postoperative day. RESULTS: Two hundred patients were enrolled in the study; 107 patients were assigned to the early feeding group and 93 patients to the conventional feeding group. There were no significant differences in the demographic data between the two groups. In all cases, consistent anesthetic method was applied with no intraoperative adhesion and no post operative complications were observed. The rate of mild ileus symptoms in the early feeding group was significantly less than the conventional group (19.6% versus 31.1%, p = 0.03). The early feeding group also had significantly shorter time interval to bowel movement (16.7 hours versus 25.3 hours, p < 0.001), duration of intravenous fluid administration (20.5 hours versus 24.8 hours, p < 0.001), and overall length of hospital stays (3.3 days versus 4.0 days, p < 0.001). CONCLUSION: The study results indicated that the early feeding after uncomplicated cesarean section had reduced the rate of ileus symptoms and offer potential benefits associated with shorter interval to bowel movement, intravenous fluid administration, and length of hospital stays. However, management of postoperative feeding requires proper counseling on details of both regimens and flexibilities should be provided to accommodate early feeding when requested by the patients.
Authors: Miles Murphy; Cedric Olivera; Thomas Wheeler; Elizabeth Casiano; Nazema Siddiqui; Rajiv Gala; Tondalaya Gamble; Ethan M Balk; Vivian W Sung Journal: Int Urogynecol J Date: 2012-08-08 Impact factor: 2.894