Low-Dose Ketamine as a Perioperative Multimodal Regimen

Abstract

Background: Postoperative opioid consumption has caused surgical complications such as postoperative nausea and vomiting (PONV), respiratory failure, and prolonged hospital stay. The culprit of the epidemic opioid crisis in the United States (U.S.) is opioid exposure after surgery. The American Society of Anesthesiologists (ASA) recommends using multimodal pain management for all surgical patients to decrease opioid consumption and its complications. Ketamine, an N-Methyl-D-aspartate (NMDA) receptor antagonist, is an effective multimodal pain regimen that decreases postoperative pain and opioid consumption without increasing risk of severe side effects. Objective: The purpose of this DNP project was to increase knowledge of ketamine as a multimodal pain regimen among the anesthesia providers and student nurse anesthetists at a regional medical center in Southern California. Design: This descriptive study includes a pre-questionnaire to assess the current knowledge of ketamine, an educational session, and a post-questionnaire after the educational session to assess increased knowledge of ketamine. Measurements: The primary measurement includes the increase in knowledge of ketamine regarding time and frequency of administration, types of surgery that can be beneficial from ketamine, and financial advantages. The secondary measurement assesses barriers to adding ketamine to current practice.