Enhanced Recovery After Cardiac Surgery (ERAS)

James Cook University Hospital

Status

Unknown

Conditions

Mitral Valve Disease

Coronary Artery Disease

Cardiac Surgery

Aortic Root Dilatation

Aortic Valve Disease

Tricuspid Valve Disease

Treatments

Drug: Post-operative Ondansetron anti-emesis

Dietary Supplement: Pre-operative Carbohydrate PreLoad drink

Drug: Intravenous Ondansetron intra-operatively

Procedure: Early mobilisation/physiotherapy

Drug: Intravenous Magnesium intra-operatively

Procedure: Early extubation

Drug: Intravenous Paracetamol intra-operatively

Drug: Infiltration of surgical wounds with local anaesthetic

Drug: Oral Gabapentin pre-op

Drug: Oral Lansoprazole pre-op

Drug: Post-operative Gabapentin analgesia

Other: Encourage early oral food intake

Drug: Intravenous Dexamethasone intra-operatively

Drug: Post-operative oral Paracetamol analgesia

Study type

Interventional

Funder types

Other

Industry

Identifiers

NCT03859102

IRAS242926

Details and patient eligibility

About

Enhanced Recovery Protocols (ERPs or bundles) have been established in many surgical specialties (such as colon cancer and orthopaedic joint surgeries) for several years in hospitals worldwide. The principles of Enhanced Recovery Protocols are those of early mobilization and restoration of normal function as soon as possible after surgery. These principles are achieved by use of alternate pain control regimens and removing invasive lines and drains as soon as possible. The benefits of ERPs are improved patient experience, earlier return to normal function and reduced length of stay. Enhanced recovery protocols for cardiac surgery have been published by the Enhanced Recovery After Cardiac Surgery Society.

The current study will investigate whether it is possible to utilise ERP bundles in the population of cardiac surgery patients at James Cook Hospital, with a view to rolling out a full ERP service. Secondary study outcomes will be patient-centred, including; pain scores, nausea and vomiting rates and time taken to return to normal function.

Full description

Why? Enhanced Recovery Protocols (ERPs or bundles) have been established in many surgical specialties (such as colon cancer and orthopaedic joint surgeries) for several years in hospitals worldwide. The principles of Enhanced Recovery Protocols are those of early mobilization and restoration of normal function as soon as possible after surgery. These principles are achieved by use of alternate pain control regimens and removing invasive lines and drains as soon as possible. The benefits of ERPs are improved patient experience, earlier return to normal function and reduced length of stay. Enhanced recovery protocols for cardiac surgery have been published by the Enhanced Recovery After Cardiac Surgery Society. These protocols have been demonstrated as safe, though have yet to make it into mainstream practice in the UK. The use of ERPs in Cardiac Surgery has the potential to greatly improve the patient journey and hospital efficiency.

What? The current study will investigate whether it is possible to utilise ERP bundles in the population of cardiac surgery patients at James Cook Hospital, with a view to rolling out a full ERP service. Secondary study outcomes will be patient-centred, including; pain scores, nausea and vomiting rates and time taken to return to normal function.

Who? All adult patients over the age of 18 years and listed for cardiac surgery will be considered for inclusion in this study.

Where? The study population will be comprised of patients undergoing cardiac surgery at the James Cook University Hospital in Middlesbrough.

How? Study duration will be 6 months, with 80 patients (comprising a control and intervention group)

Enrollment

80 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Having Cardiac Surgery
Aged 18 years or older at the time of consent
Deemed appropriate for ERAS by Surgeon and Anaesthetist
Able and willing to provide written informed consent

Exclusion criteria

Aged 18 years or under
Deemed not suitable for ERAS by Surgeon and/or Anaesthetist

Trial design

Primary purpose

Treatment

Allocation

Non-Randomized

Interventional model

Sequential Assignment

Masking

None (Open label)

80 participants in 2 patient groups

ERAS Control/non-ERAS group

No Intervention group

Description:

Standard usual care after cardiac surgery.

ERAS group

Experimental group