Abstract
The objective of this study was to determine the safety and efficacy of early feeding of a regular diet to high-risk, obese postoperative cesarean-section patients. The setting for this study was two charity hospitals with predominantly (99%) indigent high-risk patients. One hundred nineteen (119) patients were enrolled in the study, 63 of whom were randomly assigned to a regular diet given 6 hours postoperatively and 56 patients were randomly assigned to traditional nulla per os (nothing by mouth [NPO]) status followed by advancement of diet with resumption of traditional signs such as bowel sounds and flatus. Both groups were encouraged to ambulate and had the Foley catheter removed 6 hours postoperatively. Subjects in the early-feeding group had an earlier return to bowel function as evidenced by earlier passage of flatus and bowel movement but were slightly more likely to need bowel stimulants than the control group. Subjects were much more likely to ambulate earlier than those of the control group. Patients enrolled in the study group needed fewer doses of parenteral narcotics but no differences were noted between the groups as to the number of oral doses of narcotics or nonsteroidal anti-inflammatory drugs. No serious postoperative complications such as ileus were noted in either group. We believe that early feeding of the high-risk cesarean-section patient not only is beneficial but promotes earlier ambulation that may prevent serious postoperative complications.
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