Background
hypotension
LATE PREGNANCY, COMPLICATED PREGNANCIES, DELAYED GASTRIC EMPTYING, FETAL DISTRESS
Regional anesthesia (spinal, epidural, and combined spinal epidural [CSEA]) is the recommended standard practice for elective cesarean section because it offers a rapid onset and reliable surgical condition. In addition, it avoids the most common risks associated with general anesthesia, such as difficulty with airway management, pulmonary aspiration of gastric contents, and the negative effects of general anesthetics on the fetus. However, maternal arterial hypotension during regional anesthesia for cesarean section remains the main disadvantage, particularly for spinal anesthesia, and can result in fetal distress and maternal discomfort [Human and animal studies have found that carbohydrate loading before surgery leads to an improved response to surgical stress and postoperative conditions compared with traditional fasting guidelines. From such positive findings, PORT before elective surgeries has been recommended as an essential element of the enhanced recovery after surgery protocol. However, in general, late pregnancy causes delayed gastric emptying. The Practice Guidelines for Obstetric Anesthesia approved by the American Society of Anesthesiologists (ASA) suggests that women with uncomplicated pregnancies undergoing elective cesarean delivery should adhere to the same presurgical fasting guidelines as non-pregnant women, such as 6–8 h of no solid food and 2 h of no liquids before the scheduled surgical procedure [Our primary hypothesis with this prospective, randomized, open-label (but assessors are blinded), blinded-endpoint controlled clinical trial was to determine if preoperative intake of ORS (OS-1®) stabilized perioperative circulatory dynamics during cesarean section. We also measured stomach size using ultrasound to investigate the safety of ORS.