Date of this Version

12-6-2021

Document Type

DNP Project

Abstract

Background: Inadequate post-operative analgesia continues to pose a significant challenge in healthcare. Despite the expansion and application of innovative analgesic approaches over the past decades, more than 50% of patients experience moderate to severe pain, even after minor surgical procedures. The trend in anesthesia has been the utilization of rapid-acting opioids such as fentanyl or shorter-acting opioids such as hydromorphone. The administration of methadone exerts powerful analgesic effects through potent μ-receptor agonism, N-methyl-D-aspartate receptor antagonism, and the inhibition of serotonin and noradrenaline reuptake. It has also been used in several procedures to reduce post-operative pain and post-operative opioid consumption.

Methodology: This quality improvement project composed of 15 randomized control trials reviewed whether the intraoperative use of methadone lowers post-operative pain scores and opioid consumption in comparison to other short-acting opioids commonly utilized intraoperatively. An educational module intervention composed of a pre-assessment survey, a narrated presentation, and a post-assessment survey will assess anesthesia provider knowledge.

Results: The empirical evidence demonstrated that the administration of single-dose intraoperative methadone reduced post-operative pain scores and post-operative opioid consumption 48 hours after surgery compared to other short-acting opioids. Overall, the results reflect an improvement in methadone knowledge based on the pre-assessment and post-assessment survey results. Knowledge showed an average improvement of 11%.

Conclusion: This quality improvement educational module seeks to assess anesthesia providers’ knowledge regarding the clinical effects of single-dose intraoperative methadone. Anesthesia providers receiving the educational intervention will include Anesthesiologists and Certified Registered Nurse Anesthetists (CRNA). The sample will include approximately 5 to 10 participants. The quality improvement project will involve three phases, a pre-assessment survey, an online educational presentation, and a post-assessment survey. Pre-assessment and post-assessment surveys will be used to evaluate the effectiveness of the educational module. Statistical analysis will be applied to assess the knowledge of the educational intervention. It is projected that the provider’s education will improve regarding the clinical effect of single-dose intraoperative methadone.

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