Date of this Version

2024

Document Type

DNP Project

Rights

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Abstract

Background: Abdominal surgery is considered to be major surgery, as it potentiates a great deal of pain and initiates a systemic inflammatory response. Substandard pain protocols before, during, and after surgery can prevent patients from returning to baseline function and may predispose them to the need for rescue analgesia or opioids. A balanced anesthetic targets pain receptors before painful surgical stimuli occurs, and regional anesthesia has been recognized as a promising technique to accompany general anesthesia for abdominal procedures. TAP blocks can be administered preoperatively and intraoperatively to reduce postoperative pain yet are time- sensitive without the inclusion of adjuvants. Dexmedetomidine and its limited side effect profile has proved to be a beneficial medication when used as a TAP Block adjuvant to extend the quality and life of this block and reduce the amount of opioid consumption in post anesthesia units.

Objectives: The purpose of this quality improvement project was to enhance anesthesia provider knowledge on the benefits of selecting Dexmedetomidine as a TAP adjuvant to reduce postoperative pain and opioid consumption for abdominal surgical patients.

Methods: The primary methodology for this quality improvement project was to administer an educational module to anesthesia providers, providing knowledge and research on the prescribing of Dexmedetomidine as a TAP block adjuvant to aid in abdominal surgical patients’ postoperative pain. A pre- and post- assessment survey was utilized to measure the value of this educational intervention. This project was developed in a level 1 trauma center and distributed online to anonymous participants in survey format.

Results: Dexmedetomidine was found to be an effective selection for adjuvant use in TAP blocks by reducing the need for postoperative opioid prescribing. Dexmedetomidine’s subtle side effect profile proves it is a frontrunner for inclusion with local anesthetics to enhance TAP blocks.

Conclusion: This quality improvement project enhanced anesthesia providers’ knowledge and perspective on the inclusion of regional anesthesia when caring for abdominal surgical patients. The module also prompted a discussion on how to enhance regional blocks.

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