The Enhanced Recovery After Caesarean (ERAC) protocol, modelled on ERAS principles, recommends which of the following as a key element differing from traditional post-caesarean care?

• A Prolonged NPO status (8 hours) post-operatively to reduce aspiration risk
• B Early oral intake (clear fluids within 30 minutes), early mobilisation, multimodal analgesia with opioid minimisation, and early urinary catheter removal within 12–24 hours ✓
• C Routine use of IV patient-controlled analgesia (morphine PCA) for 48 hours
• D Delayed breastfeeding initiation until general anaesthesia metabolites clear (24 hours)

Explanation

ERAC (Enhanced Recovery After Caesarean) protocols include: pre-operative carbohydrate loading, intraoperative warming, phenylephrine infusion for spinal hypotension prevention, planned multi-modal non-opioid analgesia (intrathecal morphine + NSAIDs + paracetamol), early oral fluids and diet (within 30–60 minutes of surgery), early urinary catheter removal (within 12–24 hours), early mobilisation, skin-to-skin contact and early breastfeeding support. These reduce hospital stay, opioid use, and complications. The traditional NPO, delayed mobilisation, and prolonged catheterisation paradigm is replaced entirely.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.