Comparison of Early Hospital Outcome in Early Versus Delayed (2 Vs. 8 Hours) Oral Feeding in Females after Cesarean Section Under Regional Anesthesia

Introduction: The recommendation of oral feeding (OF) after 2 hours of the c-section (CS) under regional anesthesia (RA) should be encouraged as it results in quick postoperative recovery and lessens the time of hospitalization. Routine OF (just after hearing the bowel sounds through inspection) after CS under general anesthesia (GA) must be the final option.

Objective: This study's objective is to compare early hospital outcomes in early versus delayed (2 vs. 8 hours) oral feeding in females after cesarean section under regional anesthesia.

Materials and Methods: This randomized controlled trial was completed in 6 months (August 12, 2017, until February 12, 2018). This study included 800 patients after getting informed consent from patients/attendants who met the inclusion criteria. Data was collected from the Department of Gynaecology & Obstetrics, Lady Aitchison Lahore. Females undergoing C-sections were randomly divided into 2 groups (groups A and B) using a random number table. In Group A and Group B, females were fed early (within 2 hours) or delayed (after 8 hours) as per operational definition, respectively. Short-term hospital outcome time to bowel movement, time to passage of flatus, abdominal distension, and hospital stay were measured.

Results: The mean hospital stay in the early feeding group was (31.82 ± 11.01) hours and in the delayed feeding group was (37.24 ± 9.34) hours. The mean time to bowel sound in the early group was (15.72 ± 4.67) minutes and in the delayed group (16.84 ± 4.58) minutes. The mean time to passage of flatus in the early and delayed group was (24.06 ± 5.60) minutes and (29.66 ± 5.36) minutes. The mean hospital stay, mean time to bowel sound, and mean time to Passage of flatus in the early group were statistically lower than the delayed group, p-value < 0.001. In the early feeding group, a total of 78 (19.5%) cases had abdominal distension, and in the delayed feeding group 129 (32.2%) cases had abdominal distension, with statistically lower abdominal distension in the early group p-value < 0.001.

Conclusion: Through the findings of this study it was found that the frequency of abdominal distension, time to passage of flatus, time interval to bowel sounds, and Hospital stay was less in the early feeding group as compared to delayed groups. So, by introducing early feeding, we may reduce hospital stays and gain more female satisfaction.