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Publication Date
8-2020
Keywords
School of Anesthesia
Disciplines
Anesthesiology | Medical Education | Nursing
Abstract
Background Opioids are considered the standard of practice for intraoperative and postoperative pain management but yield unfavorable outcomes.6 The research evidence demonstrates reductions in post-operative opioid use following intraoperative administration of dexmedetomidine.1,3,4,5,6 Due to the prospective nature of literature surrounding dexmedetomidine, the rate of implementation remains largely unknown. The aim of this retrospective, observational project was to identify the rate of adoption of intraoperative dexmedetomidine administration among adult surgical patients at Providence Sacred Heart Medical Center (PSHMC) from January 1, 2015 to December 31, 2019. Accordingly, investigation into dexmedetomidine administration at PSHMC may shed light on this strategy aimed to minimize opioid exposure
Methods • Retrospective, observational evidence-based practice project. • Approved by the PSHMC Clinical Innovation and Research Council and deemed exempt from human subject's research by Providence Health Care Institutional Review Board. • Data extracted, de-identified and stored in HIPPA compliant Redcap project database. • Included adults over the age of 18 years, undergoing surgical procedure from January 1, 2015 to December 31, 2019. • Excluded pediatric patients less than 18 years of age, intranasal dexmedetomidine administration, patients undergoing outpatient procedures not admitted to the hospital, hospital length of stay less than 24 hours and greater than 14 days, and morphine equivalent dosing exceeding 200 milligrams. • Univariate and bivariate analyses examined baseline group comparability, occurrence of intraoperative dexmedetomidine administration. • Multivariable analysis examined independent risk factors associated with receiving intraoperative dexmedetomidine.
Discussion Intraoperative dexmedetomidine is an effective evidencedbased strategy to promote opioid sparing effect and reduce 24- hour opioid consumption.1,4,5,6 Findings identified a 2.5% occurrence of intraoperative dexmedetomidine and 96.3% opioid occurrence in adult surgical patients at (PSHMC) from January 1, 2015 to December 31, 2019. The occurrence of dexmedetomidine administration is not a widespread practice used at PSHMC, but its utilization is increasing. History of backpain and intraoperative opioid administration were independently associated with decreased intraoperative dexmedetomidine use. ENT, maxillofacial and oral surgery were the greatest risk factors for intraoperative dexmedetomidine administration. History of home opioid treatment was also associated with increased intraoperative dexmedetomidine use. The research evidence demonstrates that intraoperative dexmedetomidine is a promising new avenue to reduce postoperative opioid use.3,4,5,6 The purpose of this retrospective, observational project serves as a foundation for additional examination to identify and report interventions to reduce opioid administration and improve quality initiatives surrounding multimodal analgesia.
Specialty/Research Institute
Anesthesiology
Specialty/Research Institute
Nursing
Conference / Event Name
AANA 2020 Virtual Congress
Location
Virtual Conference
