ERAS after cardiac surgery is a well known protocol ,However the investigators study if it is applied at our institute

Enhanced recovery after surgery (ERAS) is a term that include a series of evidence-based perioperative care pathways designed to reduce physiological and psychological stress in surgical patients and to achieve rapid recovery.

In 2016, the first pilot study was published, which analyzed enhanced recovery after cardiac surgery (ERACS). Weaning from mechanical ventilation is considered one of the items that forms the concept of enhanced recovery in cardiac surgery.

Pain is an undesirable consequence of surgery especially cardiac surgery as pain during and following cardiac surgery has been shown to be a risk factor for increased morbidity. Systemic opioids have been the main stay for the management of perioperative pain in cardiac surgery. Lower doses of opioids has been related to early extubation and minimizing opioid-related side effects, such as prolonged ventilation, tolerance, nausea, vomiting, gut dysfunction, and immunosuppression.

On the other hand the investigators find cases of morbidity and mortality not related to the surgical procedure. ERAS protocol discuss the optimum condition that can be used to avoid the morbidity and mortality complications.

the investigators aim to know how well ERAS protocol is known and applied

Inclusion Criteria:

• Cardiac anesthesiologists.
• Cardiac intensivists.
• Cardiothoracic surgeons.
• All stuff members from resident to consultant are included inside this study

Exclusion Criteria:

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• Anesthesia department, Cairo university hospitals, kasr al-ainy.
• Cardiothoracic thoracic surgery department, Cairo university hospitals, kasr al-ainy.
• Anesthesia department, National Heart Institute.
• Cardiothoracic surgery department, National Heart Institute.