Comparison of Post-Caesarean Section Recovery Using ERACS and Conventional Methods: Systematic Review

Abstract

Background: Caesarean section (CS) is a common surgical procedure with a high incidence (32% in the US; ~23% globally). The Enhanced Recovery After Cesarean (ERACS) protocol is designed to accelerate postpartum recovery through a multidisciplinary approach (preoperative education, multimodal analgesia, early mobilization, etc.). Objective: This systematic review aims to evaluate and compare post-cesarean section recovery with ERACS and conventional methods. Methods: This study is a systematic literature review conducted based on the PICO guidelines comparing ERACS with conventional care in CS patients, focusing on three primary outcomes: length of stay, time to first mobilization, and postoperative pain score (VAS). The literature search followed the PRISMA guidelines. Results: Of the selected studies (RCTs and observational), the majority reported shorter length of stay with ERACS compared to conventional, faster mobilization time, and lower or similar pain scores with ERACS (some studies reported a significant decrease in VAS scores, while others found no significant difference). Conclusion: Implementation of the Enhanced Recovery After Cesarean Section (ERACS) protocol in Caesarean section patients significantly shortened hospital stay and accelerated first mobilization compared to conventional care, without increasing postoperative pain levels. ERACS can be considered a more efficient method in post-cesarean section recovery, while also reducing opioid use.