Immediate postoperative feeding after painless abortion alleviates patient discomfort and accelerates recovery: a retrospective cohort study

Under the guidance of enhanced recovery after surgery (ERAS), this study aims to investigate the safety and feasibility of an immediate postoperative diet regimen for patients undergoing painless abortion surgery, analyze early postoperative discomfort symptoms (including nausea and vomiting, hunger, thirst, pain, etc.) and recovery outcomes (including time to resume normal diet, length of hospital stay, and vaginal bleeding), and clarify the clinical application value of this study in clinical practice.

A retrospective cohort study was conducted on 210 patients who underwent intravenous anesthesia for painless abortion in our department from October 2024 to March 2025. According to postoperative dietary regimens, they were divided into a control group (n=109, a conventional 2-hour postoperative diet regimen from October to December 2024), and an observation group (n=101, an immediate postoperative diet regimen from January to March 2025). Primary outcome indicators included the incidence and severity of nausea and vomiting at 1, 6, and 24 h postoperatively (WHO nausea and vomiting grading), thirst and hunger discomfort scores (a graded scoring), pain scores [Numerical Rating Scale (NRS)], as well as duration of surgery, time to return to regular diet, length of hospital stay, and duration of postoperative vaginal bleeding. All data were extracted from the electronic medical record (EMR) systems and follow-up records using a standardized data extraction protocol. Data extraction was performed independently by 2 research nurses who received uniform training and were blinded to group allocation, using double independent data extraction and entry; discrepancies were evaluated by a third party to ensure the authenticity and reliability of the data.

There were no statistical differences between the 2 groups in baseline characteristics such as age, gravidity and parity, BMI, and duration of amenorrhea (P>0. 05). The incidence and severity of nausea and vomiting at 1 and 6 h postoperatively were significantly lower in the observation group than in the control group (Cliff’s delta=0. 201, 95%CI: 0. 048 to 0. 354; Cliff’s delta=0. 393, 95%CI: 0. 249 to 0. 537, P<0. 05). The scores for postoperative thirst and hunger discomfort were significantly lower in the observation group than in the control group (Cramer’s V=0. 411, 95%CI: 0. 295 to 0. 527, P<0. 001). Compared with the control group, the observation group exhibited significantly lower pain scores at 6 h postoperatively (1. 12±1. 13 vs 2. 26±0. 91, mean difference: -1. 14, 95%CI: -1. 41 to -0. 87, P<0. 001), shorter time to return to regular diet (143. 70±56. 39 vs 361. 07±144. 45 min, mean difference: -217. 37, 95%CI: -249. 39 to 185. 35, P<0. 001), reduced length of hospital stay (61. 46±19. 13 vs 69. 43±14. 11 min, mean difference: -7. 97, 95%CI: -12. 54 to -3. 40, P<0. 001), and fewer days of postoperative vaginal bleeding (5. 58±1. 96 vs 6. 71±2. 08 d, mean difference: -1. 13, 95%CI: -1. 68 to -0. 58, P<0. 001).

Under the guidance of ERAS, the immediate postoperative feeding regimen for patients undergoing painless abortion is safe and feasible, effectively alleviating postoperative nausea, vomiting, and abdominal pain, reducing discomfort such as thirst and hunger, shortening postoperative hospital observation time and duration of vaginal bleeding, and further improving nursing quality and patient experience.