Enhanced Recovery After Cesarean (ERAC) protocols recommend which intervention to reduce time to ambulation and reduce postoperative ileus after elective cesarean section?

• A Routine nasogastric tube insertion and NPO for 8 hours post-procedure
• B Parenteral nutrition for 24 hours until bowel sounds return
• C Intravenous dexamethasone and metoclopramide for 48 hours prophylactically
• D Early oral hydration/feeding within 2 hours, multimodal non-opioid analgesia, and early ambulation at 4–6 hours ✓

Explanation

ERAC (also ERAS for cesarean) bundles include: early oral fluids/feeding (within 2 hours post-procedure), multimodal analgesia minimizing opioids (neuraxial opioids, NSAIDs, acetaminophen, TAP blocks), early removal of urinary catheter, early mobilization at 4–6 hours, and skin-to-skin contact. These interventions reduce hospital stay, ileus, thromboembolism risk, and improve patient satisfaction. Nasogastric tubes, prolonged NPO, and parenteral nutrition are not part of modern ERAC and may delay recovery.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.