{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:00:09Z","timestamp":1790661609636,"version":"4.1.0"},"reference-count":42,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Enhanced Recovery After Surgery (ERAS) protocols have been implemented in various surgical specialties to improve patient outcomes and reduce opioid consumption. In cardiac surgery, the traditionally high-dose opioid use is associated with prolonged ventilation, intensive care unit (ICU) stays, and opioid-related adverse drug events (ORADEs). This study evaluates the impact of an ERAS\u00ae Society-certified program on opioid consumption in patients undergoing elective cardiac surgery at Lausanne University Hospital. Methods: A retrospective, monocentric observational study was conducted comparing two patient cohorts: one treated with ERAS protocols (2023\u20132024) and a retrospective control group from 2019. Data were collected from the hospital\u2019s electronic medical records and the ERAS program database. The primary outcome was total opioid consumption, measured intraoperatively and postoperatively (postoperative day (POD) 0\u20133). Secondary outcomes included pain control, length of stay, complications, and recovery parameters. Statistical analyses included multivariate logistic regression to identify factors associated with reduced opioid consumption. Results: Patients in the ERAS group demonstrated significantly lower total opioid consumption, whether intraoperatively (median sufentanil: 40 mcg vs. 51 mcg, p &lt; 0.0001) or postoperatively (POD 0\u20133: p &lt; 0.001). The ERAS group had faster extubation times, earlier mobilization and pain control with non-opioid analgesics, fewer complications, and shorter hospital stays (9 vs. 12 days, p &lt; 0.001). Logistic regression identified fast-track extubation and absence of complications as strong predictors of reduced opioid use. Conclusions: The implementation of an ERAS protocol in cardiac surgery significantly reduces opioid consumption while enhancing recovery.<\/jats:p>","DOI":"10.3390\/jcm14051768","type":"journal-article","created":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T04:55:08Z","timestamp":1741236908000},"page":"1768","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Enhanced Recovery After Surgery (ERAS) Protocols in Cardiac Surgery: Impact on Opioid Consumption"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7768-6010","authenticated-orcid":false,"given":"Alexandra","family":"Othenin-Girard","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9199-4415","authenticated-orcid":false,"given":"Zied","family":"Ltaief","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5354-1017","authenticated-orcid":false,"given":"Mario","family":"Verdugo-Marchese","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4123-5776","authenticated-orcid":false,"given":"Luc","family":"Lavanchy","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice","family":"Vuadens","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Nowacka","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyad","family":"Gunga","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentine","family":"Melly","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9560-6723","authenticated-orcid":false,"given":"Tamila","family":"Abdurashidova","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Botteau","sequence":"additional","affiliation":[{"name":"Department of Cardio-Respiratory Physiotherapy, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8114-8908","authenticated-orcid":false,"given":"Marius","family":"Hennemann","sequence":"additional","affiliation":[{"name":"Department of Cardio-Respiratory Physiotherapy, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00f4me","family":"Graf","sequence":"additional","affiliation":[{"name":"Faculty of Biology and Medicine, University of Lausanne (UNIL), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5370-048X","authenticated-orcid":false,"given":"Patrick","family":"Schoettker","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland"},{"name":"Faculty of Biology and Medicine, University of Lausanne (UNIL), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9213-7578","authenticated-orcid":false,"given":"Matthias","family":"Kirsch","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland"},{"name":"Faculty of Biology and Medicine, University of Lausanne (UNIL), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Rancati","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1056\/NEJM196912182812503","article-title":"Cardiovascular response to large doses of intravenous morphine in man","volume":"281","author":"Lowenstein","year":"1969","journal-title":"N. 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