Introduction Currently various strategies are being developed for fast tracking in cardiac anaesthesia that includes use of shorter acting opioids , combined thoracic epidural or high spinal anaesthesia with GA, awake cardiac surgery along with normothermic or mild hypothermic cardiopulmonary bypass (CPB) and off pump surgeries. The aim of fast tracking is early extubation, early mobilization, decreased length of ICU and overall hospital stay, not only to reduce costs and human resource utilisation but also to reduce the postoperative morbidity and mortality while enhancing the quality of health care.