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Research Snapshot Theater: Research, Adult II

Impact of Multimodal Analgesia in Cardiac Surgery Patients via Enhanced Recovery After Surgery Order

Tuesday, March 24, 2026
11:15 AM - 12:15 PM Central Time
Location: Connections Central - RST 16
Introduction: Opioids have been the mainstay for postoperative analgesia in cardiothoracic surgery patients; however, opioids are associated with many adverse drug events (ADEs). There has been a growing shift towards alternative approaches to minimize opioid induced ADEs while optimizing recovery outcomes. An Enhanced Recovery After Surgery (ERAS) pilot, including non-opioid analgesics, was recently implemented for coronary artery bypass graft (CABG) procedures under a single cardiothoracic surgeon in May 2024 across two community hospitals. This research project assessed the impact of multimodal analgesia facilitated through the ERAS CABG order-set as compared to the non-ERAS (conventional) CABG order-set.


Methods: This was an IRB-approved, multi-site, retrospective cohort chart review of patients admitted to two community hospitals for a CABG procedure from May 2024 to January 2025. Patients with utilization of both pre- and post-ERAS CABG order-sets or pre- and post-conventional CABG order-sets were included. The primary outcome was the mean opioid consumption in morphine milligram equivalents (MME) overall and for every 24-hour period up to 72-hours post-operatively. The secondary outcomes were the mean pain score overall and for every 24-hour period up to 72-hours post-operatively, time to extubation, non-opioid pain medication usage, documented opioid related toxicities, post-operative and intensive care unit (ICU) lengths of stay, and 30-day readmission rate.


Results: A total of 106 patients were included in this study with 53 patients each in the ERAS and conventional groups, respectively. The overall mean opioid consumption was 10.4 ± 9.22 MME versus 17.9 ± 8.97 MME (p-value < 0.001), respectively. The overall mean pain score was 4.53 ± 2.06 versus 5.24 ± 1.44 (p-value 0.041), respectively. The mean ICU LOS was 2.98 ± 1.01 days versus 3.74 ± 1.70 days (p-value 0.008), respectively. Lastly, higher incidences of constipation and ileus were reported in the conventional group.


Conclusions: Implementation of an ERAS program for CABG procedures demonstrated that an ERAS-based multimodal analgesia regimen resulted in decreased opioid consumption, decreased non-opioid analgesic requirements, improved pain scores (49-72 hours post-operatively), and decreased ICU length of stay