Enhanced Recovery After Surgery (ERAS) protocols have been implemented in many institutions to atten¬uate the stress of surgery and facilitate early recovery. Careful selection of multimodal analgesic medication plays an essential role in achieving the goals of ERAS protocols. Clonidine and dexmedetomidine are α2-adrenergic receptor (α2-AR) agonists that can greatly enhance various ERAS components owing to their unique pharmacologic properties: antinocicep¬tion, anxiolysis, anti-inflammation, and renal protection. The α2-AR agonists exert supraspinal and spinal antinociceptive effects by potentiating descending pain modulatory pathways and inhibiting peripheral C fibers. These antinociceptive effects of α2-AR ago¬nists are independent of opioid receptors and result in analgesic synergy with opioid agonists. Several meta-analyses and systematic reviews have reported that α2-AR agonists decrease opioid consumption and side effects in adult and pediatric surgical patients. Given the wide distribution of α2-ARs in the body, α2-AR agonists have been associated with a reduction in anxiety, perioperative stress, inflammation, postoperative nausea and vomiting, shivering, and cognitive dysfunction. This course describes the basic and applied pharmacology of the α2-AR agonists and provides emerging evidence to support their utility in acute pain management and ERAS protocols. Perioperative administration of α2-AR agonists can enhance pain management, decrease adverse effects, and promote surgical recovery.

Learning Outcome(s):

1. Describe the unique analgesic properties of alpha-2 agonists’ and their mechanism of action.   
2. Discuss the current evidence-based practice of alpha-2 agonists in acute pain management in the perioperative setting.   
3. Delineate the benefits of alpha-2 agonists in improved surgical pain management outcomes.   
4. Describe the application of alpha-2 agonists in opioid and non-opioid withdrawal management.   
5. Review the potential side effects of administration of alpha-2 agonists in the perioperative setting. 

This program has been prior approved by the American Association of Nurse Anesthesiology for 1.00 Class A CE credits; Code Number 1041506; Expiration Date 12/6/2024.

Sarah Jingying Zhang, PhD, CRNA

Gloria Lai, MSN, CRNA

Charles A. Griffis, PhD, CRNA, FAANA

Michelle Schiltz, MSN, CRNA

Edwin N. Aroke, PhD, CRNA, FAAN

Accreditation Information:
The American Association of Nurse Anesthesiology is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. 

AANA is an approved provider by the California Board of Registered Nursing, CEP #10862.

Disclosure Statement:
Any relevant relationship between an ineligible company and an individual with the ability to influence clinical content will be identified by the Nurse Planner within the activity. Any relevant relationship between an ineligible company and an individual with the ability to influence clinical content has been mitigated.

Post-Test Attempt Notice:
A minimum passing score of 80% is required to pass this course. You have TWO opportunities to achieve a passing score. If you fail to achieve a passing score of 80%, you will not receive CE credit for this course.

Content Disclaimer:
The views, information, or opinions expressed within the videos and audio are solely those of the individuals involved and do not necessarily represent those of the American Association of Nurse Anesthesiology.

Course content has been prepared by the presenter/developer, and each viewer agrees that the presenter/developer is solely responsible for the content and the accuracy thereof. The viewer agrees that the American Association of Nurse Anesthesiology has no responsibility or liability for the accuracy or completeness of the content.

Refund Policy:
Continuing education activities are nonrefundable.