Improving Acute Postoperative Pain Management for Opioid-Tolerant Patients: Development of a Postoperative Ketamine Infusion Protocol

Author

Jeri DockinsFollow

Date of Award

Spring 5-2018

Document Type

DNP Project

Project Team Faculty Member

Dr. Rebecca Collier

Project Team Faculty Member

Dr. Mary Zerlan

Keywords

ketamine protocol, ketamine, opioid-tolerant, acute pain

Abstract

Anesthesia providers are encountering a growing number of opioid-tolerant patients. To date, the treatment for acute pain has been the administration of opioids. The administration of opioids leads to postsurgical complications. This project’s purpose was to improve acute pain management for opioid-tolerant patients by creating a postoperative ketamine infusion protocol. Ketamine is a noncompetitive antagonist at N-methyl-D-aspartate receptor sites involved in nociceptive and inflammatory pain transmission (Radvansky et al., 2015; Vandivelu et al., 2016). Research has demonstrated ketamine administered as a bolus dose or a continuous low-dose infusion for 24 to 48 hours postoperatively often results in a decrease in opioid consumption and postoperative pain scores with few adverse effects (Adam et al., 2005; Barreveld et al., 2013; Elia & Tramèr, 2005; Jouguelet-Lacoste et al., 2015; Kim et al., 2013; Laskowski et al., 2011; .Loftus et al., 2010; McCartney et al., 2004; Remérand et al., 2009; Subramaniam et al., 2004; Urban et al., 2008; Yamauchi et al., 2008; Zakine et al., 2008). This project utilized a non‑experimental design. Staff attended a verbal educational presentation and completed a 10-question survey. Study results implied this presentation increased staff knowledge. This postoperative ketamine infusion protocol may have a significant impact on anesthesia practice.

Recommended Citation

Dockins, Jeri, "Improving Acute Postoperative Pain Management for Opioid-Tolerant Patients: Development of a Postoperative Ketamine Infusion Protocol" (2018). Doctor of Nursing Practice Projects. 4.
https://spark.siue.edu/dnpprojects/4

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