Fast-Track in Cardiac Anesthesia Cardiac Surgery in the Era of ERAS

This book, focused on fast-track approaches in cardiac surgery, covers ERAS cardiac guidelines, explores the application of loco-regional anesthesia in cardiac surgery, and addresses all aspects related to early extubation in this context. The volume includes:

• A comprehensive description of all minimally invasive cardiac procedures, with detailed anesthetic considerations for each.
• An in-depth examination of perioperative pain management, emphasizing opioid-sparing strategies and the use of chest wall blocks as a key component in fast-track protocols.
• A thorough analysis of early extubation, including its impact on length of stay and cost.

Additionally, the book provides insights into future developments by examining Ultra-Fast-Track extubation and awake surgery.

As one of the first books to focus entirely on fast-track and ERAS guidelines for early extubation of cardiac surgery patients, this volume is particularly valuable for anesthesiologists, intensivists, surgeons, and cardiologists.

Introduction.- Society for Enhanced Recovery After Cardiac Surgery.- ERAS Recommendations.- Assessment and pathophysiology of pain in cardiac surgery.- Multi-modal opioid sparing.- Locoregional Anesthesia in Cardiac Procedures.- Anatomy and ultrasound. General considerations.- Anterior and posterior chest wall anatomy.- Anterior and posterior abdominal wall anatomy.- Anterior and posterior chest wall blocks.- Anterior and posterior abdominal wall blocks.- Analgesia vs Anesthesia.- Chronic pain and fascial blocks.- Hemodynamic implications.- Pain monitoring.- Minimally Invasive Cardiac Procedures and Locoregional Anesthesia.- TAVI.- MITRACLIP.- MINI thoracotomy.- MINI sternotomy.- Early Extubation After Cardiac Procedures.- Risks and benefits.- Patients selection.- Postoperative implications.- Future Considerations In Cardiac Surgery.- Ultrafast-Track extubation.- Awake surgery.- Hospital cost and length of stay.- Clinical Cases.

Giuseppe Sepolvere is chief anesthesiologist at the department of Anestehsia and Cardiac Surgery Intensive Care Unit San Michele Hospital, Maddaloni, Caserta, Italy. His most important skill is related to the use of ultrasounds for peripheral, fascial and central nerve blocks. He also acts as training tutor for the use of ultrasounds for peripheral, fascial and central nerve blocks during courses and conferences and the applications of the thoracic fascial blocks for the postoperative cardiac surgery pain management. From January 2018 member of the ESRA board of directors Italian chapter - secretary of the ESRA board for the years 2022-2024. Dr. Sepolvere is author of scientific publications related to ultrasound blocks, has edited 1 book and several book chapters.

Simona Silvetti is a cardiac anesthesiologist in cardio-thoraco vascular anesthesia and Intensive Care Unit at IRCCS San Martino University Hospital in Genoa. She degreed and applied her anesthesiology formation in San Raffaele University of Milan. Dr. Silvetti has dedicated much of her time in collaborating on scientific research projects particularly focused on cardiac anesthesiology. She is an editorial member for Frontiers in Anesthesiology and Signae Vitae. Dr. Silvetti has published more than 50 peer-reviewed articles and she is a board member of ITACTAIC (Italian Association of Cardiothoracic Anesthesiology and Intensive Care) from 2019.