Patient Population
The current study was a single-center, IRB approved, prospective, sequentially allocated, non-randomized quality improvement trial. Any patient undergoing either elective or urgent cardiac surgery deemed appropriate for fast track to extubate was eligible for inclusion in the study, including both PRN and ERAS arms. Any patient undergoing non-emergent surgery was eligible for the fast track to extubate pathway.
Data were collected over a 7-month period in 2019. For the first 3 months of the study, any eligible participant received the traditional PRN narcotic regimen which included medications such as hydrocodone/acetaminophen and oxycodone/acetaminophen PRN. These patients are denoted as the “PRN” group. The ERAS protocol was then introduced for all eligible patients at a single medical center. Following a 1-month protocol optimization period, eligible patients were treated using the ERAS pain management protocol over the subsequent 3 months. These participants are denoted as the “ERAS” group. The full pre- and post-operative ERAS protocols are shown in Figures 1 and 2 .