Playing Our Part in Enhanced Recovery Pathways

Utilizing enhanced recovery pathways is not a new phenomenon, though the cachet of speedy recovery after surgery is certainly gaining momentum. As described by Drs. Cata and Joshi in their article “Recovery After Surgery: A Matter of Definitions,” Engelman and associates described “fast-track recovery” of the coronary bypass patient in 1990.¹  In my own practice at the time, we also accomplished early extubation – within two hours of arrival in the ICU – of cardiac surgery patients. This goal was achieved primarily by educating the ICU nurses to not administer, in a knee-jerk manner, post-op opioids as soon as the patient was turned over to their care. Furthermore, Drs. Cata and Joshi discuss how our physician definition of recovery may not really mesh with that of the patient and his or her family, and certainly it does not correlate well with true physiological recovery. Merely because a patient meets...