Date of Award
4-2019
Degree Name
Nursing (D.N.P.)
Department
College of Nursing
First Advisor
Karen Burritt PhD, RN
Second Advisor
Rachel Catinella
Third Advisor
Della Hughes-Carter
Abstract
Introduction: Spinal surgeries are among the top procedures responsible for the highest degree of post-surgical pain. Opioids are the mainstay of current pain management practices in the post-operative period. In light of the opioid epidemic, increased opioid tolerance, and changes in legislation, there is a calling for alternative strategies in managing acute and chronic pain. The purpose of this project is to answer the following question: Does implementation of an evidence-based intervention for preoperative administration of gabapentin reduce patients’ perception of pain and reduce opioid consumption in those who experience lumbar spine surgery?
Objectives: The goal of this project is to evaluate the impact of preoperative gabapentin on patient reported pain while reducing the number of opioids required post-operatively in lumbar spine surgery patients. Reduction in opioid requirements may limit side effects common to opioids including urinary retention, sedation, and nausea.
Methods: This quality improvement project was implemented with the neurosurgical team at a hospital in the Midwestern United States. Gabapentin was administered to patients who are gabapentin naïve approximately one hour prior to lumbar spine surgery. Patient reported pain, opioid use, length of stay, adverse effects, and readmissions were compared pre and post implementation to determine effectiveness of preoperative gabapentin administration.
Results: Expected results include improvement in patient perception of pain, reduction in opioid use, fewer adverse effects, shorter length of stay, and fewer readmissions for pain control.
Conclusions: Gabapentin may be effective in reducing patient perceptions of pain and opioid requirements following lumbar spine surgery. Further study with larger sample sizes are needed.
Implications: Gabapentin should continue to be administered preoperatively to patients prior to lumbar spine surgery to improve pain, reduce opioid requirements and improve post-operative adverse effects.
ScholarWorks Citation
Draper, Mary R., "Implementation of an Evidenced-Based Intervention for Pain Management in Lumbar Spine Surgery" (2019). Doctoral Projects. 57.
https://scholarworks.gvsu.edu/kcon_doctoralprojects/57
