Enhanced recovery after surgery (ERAS) protocol facilitates faster functional patient recovery in elective cardiac surgery

Introduction: Fast-track cardiac surgery today is an established and safe method because of achieved early tracheal extubation that leads to decreased length of hospital stay (LOS) with no increased risk of complications. However, we hypothesized, that fast-track protocols not only improve such system-oriented outcomes as LOS or complication rate, but facilitate better patient-oriented outcomes such as functional recovery. Our fast-track protocol was based on ERAS society guidelines, which became a “golden standard” in perioperative care in various types of surgery. Functional recovery was assessed by a novel and validated tool – Postoperative Quality Recovery Scale (PQRS) which consists of physical, psychological, functional and cognitive domains. Continuous real time tracking of recovery allowed identification of patients in need of treatment adjustment, as poor recovery leads to increased morbidity and mortality. Aim of the study: To compare ERAS fast-track protocol and conventional perioperative care in terms of functional patient recovery in elective cardiac surgery. Material and methods: We compared 41 consecutive patients undergoing elective cardiac surgery based on ERAS protocol (preoperative education, optimization of chronic conditions, no prolonged fasting and bowel preparation, carbohydrate loading, combined low-dose opioid general/epidural anesthesia, multimodal postoperative analgesia, early extubation, mobilization and feeding) (ERAS group) with cohort of 58 elective patients from 2016 who received conventional perioperative care (Control group). All of the patients were assessed with PQRS at these time points: baseline – a day before surgery, 1st, 7th and 30th postoperative days. Recovery was defined as return to the baseline or better. Statistical analysis was performed using the SPSS 20.0 software package. Chi-square test was used to find differences between groups. The results were [...]