Effects of Sugammadex on Women of Childbearing Age

Abstract

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to increase knowledge among Certified Registered Nurse Anesthetists (CRNAs) at a general acute care hospital in Phoenix, Arizona, regarding the effects of Sugammadex on women of childbearing age.Background: Anesthesia providers are crucial in ensuring patient safety during surgical procedures. However, there are gaps in knowledge about the effects of Sugammadex on women who are on contraceptives, breastfeeding, or pregnant. Sugammadex, which is used for reversing neuromuscular blockade, could bind with hormonal contraceptives containing estrogens and progestin, rendering them ineffective for up to 7 days post-administration (Do & Cho, 2023). This interaction could diminish contraceptive efficacy and potentially lead to unintended pregnancy if the patient didn’t use alternative methods of contraception. Methods: The primary methodology employed in this project involved implementing a targeted educational intervention aimed at enhancing CRNAs' knowledge of the effects of Sugammadex on women of childbearing age. This intervention consisted of a focused educational presentation followed by administering an electronic survey using Qualtrics. The survey included ten questions to gauge the participants' knowledge of the presented material. Results: Out of the 90 anesthesia providers who were invited to participate in the study, 26 provided a response, resulting in a response rate of 29%. Following an educational intervention, significant improvements in knowledge were observed regarding the effects of Sugammadex on women of childbearing age. Mean scores rose across all survey questions, with the most significant increases seen in areas such as understanding hormonal interactions (1.39 points), recommendations for pregnancy and lactation (1.85 points), fetal safety (1.54 points), and the low risk of breast milk transfer (1.58 points). Statistically significant improvements (p < 0.05) confirmed the effectiveness of the intervention in enhancing knowledge consistency among participants. Conclusions: This quality improvement project effectively enhanced CRNAs' knowledge and confidence regarding the reproductive health implications of Sugammadex, particularly its effects on hormonal contraceptives, pregnancy, and lactation. By addressing this critical knowledge gap, the project emphasizes the importance of integrating reproductive health discussions into anesthesia practice, thereby supporting informed consent and ensuring patient safety. Ongoing education and the standardization of informed consent protocols for female patients of childbearing age can further reinforce these practices within routine anesthesia care, promoting safer outcomes and improving provider-patient communication.