Enhanced Recovery After Surgery (ERAS) programs are developing rapidly in multiple specialties, fueled by the promising outcomes in colorectal surgery. There are currently few ERAS clear guidelines for cardiac surgery. the elevated burden of mortality, morbidity, and high resource expenditures associated with cardiac surgery present a tremendous opportunity for enhanced recovery, offering the possibility to explore additional potential areas of interest.

RA techniques have the potential of providing significant analgesia in a multimodal pain management model, aiming to reduce perioperative opioid use in the cardiac surgery and cardiac related procedure setting. At this point, most available data are based on case reports and small case series. Few prospective randomized trials seem to confirm feasibility, efficacy, and an opioid sparing effect. Still, the quality of data does not allow any firm conclusions to be made. There is a significant risk of overestimating treatment effects with the mostly small sample sizes. Additionally, safety recommendations also require large prospective data collection. Overall, there is hope to stimulate interest and that well-designed, controlled and blinded studies will follow in the near future providing more insight into this topic.