An Educational Intervention for CRNAs on the Use of Non-Opioid Analgesics in the Gynecological Population: A Retrospective Chart Review and Qualitative Survey
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Objective: Non-opioid analgesics provide pain control while avoiding detrimental side effects caused by opioids such as nausea and vomiting, respiratory depression, and opioid dependence. This study aimed to determine the effect of hour long educational intervention given to CRNAs about the use of non-opioids in gynecological surgery patients on the use of non-opioid analgesics, postoperative pain scores, and length of stay in the PACU. A secondary aim was to determine CRNA perceived barriers to implementing non-opioid analgesics into practice. Theoretical Framework: Kurt Lewin’s Change Theory Methods: A CRNA educational session was presented at one local hospital. Pre-intervention and post-intervention non-obstetric gynecological surgery patient charts were reviewed 30 days before and after the intervention. Data was collected on the number of non-opioids administered/prescribed by a CRNA, postoperative pain scores in phase 1, and length of stay in phase 1. A Likert-survey was disseminated to CRNAs 2 weeks after the intervention to determine perceived barriers. Results: Patients after the educational intervention received non-opioids significantly more; had a significantly decreased length of stay in phase 1 recovery; and had significantly less pain at 75 and 90 minutes (p < 0.05). Pain scores did not significantly change at 15, 30, 45, 60, 105, and 120 minutes. CRNAs reported that perceived barriers included anesthesiologist and surgeon reluctance and cost of medications. Discussion: Data confirmed that an educational session for CRNAs on non-opioid analgesics may decrease length of stay in phase 1 recovery and increase the number of non-opioid analgesics administered to gynecological surgery patients.