Untitled

Abstract

Enhanced recovery after surgery protocols (ERAS ® ) have become increasingly popular in the past few decades. Initially instituted by colorectal and gynecologic surgery, these optimized "fast track" pathways have expanded across surgical sub-specialties. We discuss critical components of such pathways, the implementation process, and particular facets of perioperative care that apply to various surgical subspecialties including cardiac, colorectal, gynecologic, and thoracic surgery. The spirit of ERAS ® emphasizes a continuous internal auditing process. ERAS ® protocols are known for faster recovery, shorter length of stay, improved pain control, and optimization of a patient's perioperative course by way of a standardized protocol. The unique aspects of enhanced recovery after thoracic surgery (ERATS) protocols are discussed. We focus on intercostal nerve blocks as an important component of ERATS pathways and optimized postoperative pain control. Intercostal nerve blocks in thoracic surgery allow for excellent postoperative pain control, which is critical for early ambulation, improved chest physiotherapy and easier progression through the post-operative course. This mini-review serves to highlight key features of ERAS ® , salient aspects of niche surgical specialties, and focuses on thoracic surgery enhanced recovery protocols and intercostal nerve blocks in the context of ERATS for optimized postoperative pain control.