Jaffer Arzina, Yang Kayleigh, Ebrahim Alisha, Brown Amy N, El-Andari Ryaan, Dokollari Aleksander, Gregory Alex J, Adams Corey, Kent William D T, Fatehi Hassanabad Ali
Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB T6G 2X8, Canada.
Department of Anesthesiology and Pain Medicine, University of Calgary, Calgary, AB T2N 2T9, Canada.
Med Sci (Basel). 2025 Aug 14;13(3):128. doi: 10.3390/medsci13030128.
Enhanced Recovery After Surgery (ERAS) is an evidence-based, holistic perioperative recovery protocol intended to improve patient outcomes and decrease postoperative complication rates. While ERAS protocols were first introduced in 1997, specific guidelines for cardiac surgery were not established until 2019. Although the core principles of ERAS remain constant across surgical disciplines, ERAS guidelines for cardiac surgery have remained relatively understudied, likely due to the unique complexities posed by cardiac procedures. Within this comprehensive narrative review, we aimed to explore the current guidelines and evidence for ERAS in both cardiac and non-cardiac surgeries. In non-cardiac surgeries, ERAS has been shown to improve various outcomes, including ICU length of stay, patient satisfaction, and pain management. ERAS for cardiac surgery has also shown encouraging results, including shorter ICU and hospital stays, reduced postoperative opioid use, and faster recovery times. However, there is limited consensus across studies, particularly regarding its impact on morbidity and mortality, with mixed results reported. Furthermore, the limited data on the efficacy of ERAS in minimally invasive cardiac surgeries makes it difficult to establish well-supported guidelines for these procedures. Despite its limitations, the overall outcomes of ERAS for cardiac surgery remain promising. As our understanding and application of ERAS in cardiac surgery continue to evolve, these protocols have the potential to redefine cardiac surgical care standards.
术后加速康复（ERAS）是一种基于证据的整体围手术期康复方案，旨在改善患者预后并降低术后并发症发生率。虽然ERAS方案于1997年首次引入，但心脏手术的具体指南直到2019年才确立。尽管ERAS的核心原则在各个外科领域保持不变，但心脏手术的ERAS指南相对研究较少，这可能是由于心脏手术带来的独特复杂性。在这篇全面的叙述性综述中，我们旨在探讨心脏手术和非心脏手术中ERAS的当前指南和证据。在非心脏手术中，ERAS已被证明能改善各种预后，包括重症监护病房（ICU）住院时间、患者满意度和疼痛管理。心脏手术的ERAS也显示出令人鼓舞的结果，包括缩短ICU和住院时间、减少术后阿片类药物使用以及更快的恢复时间。然而，各研究之间的共识有限，特别是关于其对发病率和死亡率的影响，报道结果不一。此外，关于ERAS在微创心脏手术中疗效的有限数据使得难以建立针对这些手术的充分支持的指南。尽管存在局限性，心脏手术ERAS的总体结果仍然很有前景。随着我们对ERAS在心脏手术中的理解和应用不断发展，这些方案有可能重新定义心脏手术护理标准。
