Improving Anesthesia Providers’ Knowledge on Single-Shot Versus Continuous Catheter Peripheral Blocks As Tools of Opiate-Free Analgesia

Abstract

Purpose: The purpose of this Doctor of Nursing Practice project is to improve anesthesia providers’ knowledge at Abrazo Scottsdale Campus (ASC) hospital of single-shot versus continuous catheter peripheral blocks as tools of opiate-free anesthesia. Background: Opiate-free anesthesia and analgesia is a technique of opioid-sparing or omitting methods with the purpose of opioid avoidance. Regional anesthesia in the form of peripheral nerve blocks is increasingly used as a tool for opiate-free anesthesia. Peripheral nerve blocks can be administered as a single-shot and/or as a continuous infusion to help with perioperative pain, as well as decrease the amount of opiates used postoperatively. The literature research determined that continuous catheter infusion for interscalene (after 24-48 hours) and adductor canal blocks were superior as compared to single-shot. Additionally, the interscalene block at less than 24 hours was the only superior single-shot block. Methods: The primary investigator presented an in-person educational PowerPoint presentation on single-shot versus continuous catheter infusion as methods of opiate-free anesthesia to improve providers’ knowledge at Abrazo Scottsdale Campus. The outcome measures included demographic data and post-pre-surveys with an assessment of attitudes toward change of practice based on the evidence-based literature. The surveys were collected using Qualtrics XM software. Descriptive statistics were used to analyze the data and report results. Results: Based on the demographic survey, most of the participants were males (80%). All the participants were 30-59 years old (100%) with reported varying years of experience (0-20 years). Of the participants who took the demographics survey, 60% were Certified Registered Nurse Anesthesiologists and 40% were Resident Registered Nurse Anesthesiologists. Only 33% of the participants felt they would change their practice before hearing the educational presentation. This number increased to 67% for both upper and lower extremity blocks as evidenced by answering “strongly agree” in the post-score survey. Conclusions: The results from this quality improvement project determined that the education session helped anesthesia providers’ knowledge in determining the superiority of one technique versus another (single-shot versus continuous catheter infusion for peripheral blocks) and willingness to change practice based on the evidence-based literature.