Enhanced recovery after caesarean section (ERAC) protocols include which intervention shown to reduce post-operative ileus and time to first bowel movement?
- A Early oral feeding within 2 hours of surgery with chewing gum ✓
- B Routine nasogastric tube insertion intraoperatively
- C Opioid-based multimodal analgesia as first-line
- D Prolonged IV fluid maintenance for 24 hours post-operatively
Correct answer: A. Early oral feeding within 2 hours of surgery with chewing gum
Explanation
Enhanced Recovery After Caesarean (ERAC) protocols include early oral fluid/food intake within 2 hours of surgery, which significantly reduces post-operative ileus and time to first flatus. Chewing gum stimulates cephalic-vagal stimulation of gut motility and is a simple, evidence-based adjunct. Routine NG tubes, opioid-first analgesia, and prolonged IV fluids all increase post-operative morbidity and are discouraged in ERAS/ERAC pathways.
Reference: Williams Obstetrics, 26th ed.
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