Dexmedetomidine as an Adjunct Therapy to Neuraxial Anesthesia in Labor and Delivery

Author

Anthony NungesserFollow

Date of Award

Fall 12-16-2022

Document Type

DNP Project

Project Team Faculty Member

Dr. Beth McCoy

Keywords

Dexmedetomidine, neuraxial anesthesia, spinal and epidural anesthesia, adjunt therapy, opioid-free, labor and delivery

Abstract

In 2011, the Centers for Disease Control (CDC) declared the opioid crisis an epidemic, and in 2017 it was declared a public health emergency. In labor and delivery, neuraxial anesthesia has been used for over a hundred years to provide pain relief for parturients. Although many alternatives have been studied, opioids are the most frequently used local anesthetic adjuvants, and their use in neuraxial blocks has evolved over the last 50 years (Swain et al., 2017). While neuraxial opioids have proven to be an effective adjunct for pain relief, they are associated with undesirable side effects as well as the exposure of the patient to the opioid itself. With the push for opioid-free techniques, researchers have searched for non-narcotic alternatives that can provide the same benefits as their narcotic counterparts. Dexmedetomidine (DEX) is an opioid-free, selective alpha-2 agonist that has been shown to be equal to, and in most cases, superior to opioid additives in neuraxial blockade (Qi et al., 2016).

This project aimed to educate and institute a protocol for anesthesia providers in the Obstetric department of a suburban hospital in Bradenton, FL about using neuraxial Dexmedetomidine as an opioid-free replacement for patients during the entire labor process. The sample group was given a pre-test to assess their knowledge and experience with neuraxial DEX and their initial feeling on implementing DEX into their practice. Upon completing the pre-test, the group was given a PowerPoint presentation and all questions were answered satisfactorily. Approximately two weeks after training, the sample group was given a post-test to assess knowledge retention and willingness to implement DEX into their current practice. This quality improvement project successfully provided education for the present and future anesthesia providers that participated in it. This was evidenced by the combined 64% increase in knowledge of the use of this adjunct of the licensed providers and the 87% increase in the student’s knowledge. In addition, and perhaps more importantly, roughly 32% more licensed providers replied that they were more likely to incorporate the use of this adjunct into their practice. This knowledge and willingness to implement change will benefit the anesthesia providers, nursing staff, physician staff, and, most importantly, the patients.

Recommended Citation

Nungesser, Anthony, "Dexmedetomidine as an Adjunct Therapy to Neuraxial Anesthesia in Labor and Delivery" (2022). Doctor of Nursing Practice Projects. 235.
https://spark.siue.edu/dnpprojects/235

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