• Benjamin Deniau, Nacima Bouhadjari, Valentina Faitot, Antoine Mortazavi, Gilles Kayem, Laurent Mandelbrot, and Hawa Keita.
• Service d'Anesthésie, CHU Louis-Mourier, AP-HP, Université Paris 7, 178, rue des Renouillers, 92700 Colombes, France. Electronic address: benjdeniau@gmail.com.
• Anaesth Crit Care Pain Med. 2016 Dec 1; 35 (6): 395-399.

ObjectiveTo assess the performance of a multidisciplinary programme for enhanced recovery after caesarean delivery under neuraxial anaesthesia.Study DesignProspective single-centre study.MethodsProgramme in 6 steps including 3 professional practice audits based on clinical records and questioning patients: audit T0, first "existing state", creation of a working group, drafting and implementation of a multidisciplinary rehabilitation procedure, second audit (T0+4 months), information about and implementation of corrective measures and a third audit (T0+8 months). Assessment of the performance of the continuous improvement programmes based on six measures comprising the post-caesarean rehabilitation score: duration infusion, early oral analgesia, time to removal of the urinary catheter, time to return to drinking, eating recovery time, use of carbetocin.ResultsTwo hundred and thirty-one patients were included, with 45, 64 and 122 patients at T0, T0+4 months and T0+8 months, respectively. There was a significant increase in patients who received the recovery measures (P<0.0001 for all items) between T0 and T0+8 months: removal of the infusion before 24h (49% versus 93.5%), drinking before 6h (31% versus 55%), eating before 6h (2% versus 38.5%), early oral analgesia before 24h (38% versus 95%), withdrawal of the urinary catheter before 24h (80% versus 95%), use of carbetocin (0% versus 99%).ConclusionImproved practices in rehabilitation after caesarean can be obtained by setting up a multidisciplinary programme as part of a quality approach.Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

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