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 .