From the Research
After a cesarean section under spinal anesthesia, patients can typically begin oral intake sooner than traditionally thought, with clear liquids started as soon as the patient is fully alert and has stable vital signs, usually within 1-2 hours post-surgery, as supported by the most recent and highest quality studies 1. The guidelines for breaking nil per os (NPO) status after spinal anesthesia for cesarean section have evolved over time, with a shift towards earlier oral intake.
- The primary goal is to promote faster recovery, reduce postoperative ileus, decrease hospital stay, and improve patient satisfaction.
- Spinal anesthesia causes less gastrointestinal dysfunction compared to general anesthesia, and the small intestine typically regains function within hours after surgery 2.
- However, individual assessment remains important, and patients with complications like severe nausea, vomiting, or abdominal distention may require a more cautious approach to resuming oral intake 3, 4.
- The use of ondansetron has been shown to be effective in reducing the incidence of nausea and vomiting during cesarean section under spinal anesthesia 3, 4.
- Advancement to a regular diet can occur within 4-6 hours if the patient tolerates liquids well and shows signs of bowel function returning, such as passing flatus.
- It is essential to note that the management of patients with chronic renal failure undergoing cesarean section under spinal anesthesia requires careful fluid management, as highlighted in a case study from 1996 5.
- Current clinical practice supports the use of spinal anesthesia for cesarean section, with few absolute contraindications, and offers safety, efficacy, and an improvement in maternal morbidity 1.