Chronic Opioid Use After Surgery: An Exploratory Study Examining Rural Certified Registered Nurse Anesthetist Strategies to Mitigate Chronic Opioid Use and Their View of Their Role in the Opioid Crisis-Article Chronic Opioid Use After Surgery

Article Chronic Opioid Use After Surgery

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Certified registered nurse anesthetists (CRNAs) play a significant role in providing anesthesia care in rural areas of the United States. However, these areas also have high rates of opioid prescribing and opioid-related hospital admissions and deaths. Little research has been done on the strategies CRNAs use to prevent the development of chronic opioid use after surgery. This study aimed to assess the perspectives of rural CRNAs on their role in mitigating chronic opioid use and the strategies they employ to prevent it.<br /><br />The survey was distributed to 160 CRNAs practicing in rural areas with high opioid prescribing rates. The majority of respondents (73%) agreed that they could influence whether their patients develop chronic opioid use after surgery. Those who agreed were more likely to be involved in policy development to decrease opioid use. CRNAs with a doctoral degree were also more likely to believe they could influence patient outcomes.<br /><br />The survey found that the most commonly reported strategy by CRNAs was collaboration with surgeons, followed by the use of nonopioid analgesics such as NSAIDs and ketamine infusions. Most respondents recognized the importance of patient factors such as history of chronic pain, psychological disorders, and opioid use disorder when considering the use of opioid-sparing techniques.<br /><br />However, the survey also revealed areas for improvement. Only a small percentage of CRNAs reported being very involved in limiting home opioid prescriptions. There is a need for increased integration of CRNAs in the management of home pain medication regimens.<br /><br />Overall, this study highlights the important role that CRNAs can play in mitigating chronic opioid use after surgery in rural areas. More research is needed to identify effective perioperative strategies for preventing chronic opioid use, and to support the educational advancement of CRNAs in these communities.

Keywords

Certified registered nurse anesthetists

CRNAs

rural areas

opioid prescribing

chronic opioid use

surgery

strategies

survey

patient outcomes

opioid-sparing techniques