British Journal of Obstetrics and Gynaecology
Postoperative pain after caesarean section with enhanced recovery after caesarean surgery (eracs) versus conventional care: A comparative cross-sectional study in bandung, indonesia
By Sony Darmawan, Yudo Siswo Utomo and Maisaroh Noor Amilia.
Abstract
Introduction
Caesarean section (CS) is one of the most frequently performed major operations worldwide and is still followed by moderate-to-severe acute pain in a substantial proportion of women, compromising early mobilisation, breastfeeding and maternal–infant bonding. Enhanced Recovery After Caesarean Surgery (ERACS) is an evidence-based, multidisciplinary perioperative pathway centred on opioid-sparing multimodal analgesia; nevertheless, comparative real-world data from Indonesian private hospitals remain scarce. This study aimed to compare postoperative pain intensity after CS managed with ERACS versus conventional perioperative care.
Methods
A comparative analytical cross-sectional study was conducted in the obstetrics and gynaecology inpatient ward of Hermina Arcamanik General Hospital, Bandung, Indonesia, from September to October 2025. One hundred and sixteen post-caesarean women (58 ERACS; 58 conventional) were enrolled by accidental (consecutive convenience) sampling. Pain intensity was self-rated once within 12–48 hours after surgery using the 11-point Numeric Rating Scale (NRS) and categorised as mild (1–3), moderate (4–6) or severe (7–10). The Mann–Whitney U test was applied as the primary analysis, supplemented by the effect size r and the risk ratio (RR) for moderate-to-severe pain.