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Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
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Enhanced Recovery After Surgery (ERAS) Protocols in Cardiac Surgery: Impact on Opioid Consumption
Alexandra Othenin-Girard1, Zied Ltaief2, Mario Verdugo-Marchese3
1Department of Anesthesia, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland.
Journal of Clinical Medicine
|March 17, 2025
Summary
Implementing Enhanced Recovery After Surgery (ERAS) protocols in cardiac surgery significantly reduced opioid consumption and improved patient recovery. This ERAS program led to shorter hospital stays and fewer complications.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Critical Care Medicine
Background:
- Enhanced Recovery After Surgery (ERAS) protocols aim to optimize surgical patient outcomes and decrease opioid use.
- High opioid consumption in cardiac surgery is linked to prolonged mechanical ventilation, extended intensive care unit (ICU) stays, and opioid-related adverse drug events (ORADEs).
- This study assesses the effectiveness of an ERAS Society-certified program on opioid use in elective cardiac surgery patients.
Purpose of the Study:
- To evaluate the impact of an ERAS protocol on intraoperative and postoperative opioid consumption.
- To compare patient recovery parameters, including pain control, extubation time, and length of stay, between ERAS and conventional care groups.
- To identify factors predicting reduced opioid use within the ERAS framework.
Main Methods:
- A retrospective, monocentric observational study comparing ERAS (2023-2024) and control (2019) cohorts.
- Data collection from electronic medical records and ERAS program database.
- Primary outcome: total opioid consumption (intraoperative and postoperative day 0-3). Secondary outcomes: pain, ICU stay, complications, and hospital length of stay.
Main Results:
- ERAS patients showed significantly lower intraoperative (sufentanil: 40 mcg vs. 51 mcg) and postoperative opioid consumption (POD 0-3).
- The ERAS group experienced faster extubation, earlier mobilization, improved pain management with non-opioid analgesics, reduced complications, and shorter hospital stays (9 vs. 12 days).
- Multivariate logistic regression identified fast-track extubation and absence of complications as key predictors of decreased opioid use.
Conclusions:
- Implementation of ERAS protocols in cardiac surgery effectively reduces opioid consumption.
- ERAS protocols enhance patient recovery by improving pain management and reducing complications.
- The ERAS Society-certified program demonstrates significant benefits for patients undergoing elective cardiac surgery.
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