Evaluation of the Integration of Acetaminophen and Dexmedetomidine in the Cardiac Surgery Population: Impact on the Amount of Prescribed Opioids, Respiratory and Cardiovascular Outcomes

Abstract

A high opioid technique has been used for many years during the care of cardiac surgery patients. In recent years, there has been a growing focus on opioid over-prescription and usage secondary to the opioid epidemic in our country. In response to this epidemic, many healthcare professionals are trying to integrate alternatives to opioids when treating pain. Both acetaminophen and dexmedetomidine have been recognized as potential adjuncts to general anesthesia and post-operative pain control. There is limited research on the usage of both acetaminophen and dexmedetomidine for perioperative pain management in cardiac surgery patients. This study investigated how the integration of two opioid alternatives, acetaminophen and dexmedetomidine, impacted the cardiac surgery patient. Specifically, the study evaluated how these alternatives impacted total opioid consumption throughout the perioperative timeline. The study also investigated how the integration of these medications impacted the cardiovascular and respiratory status.

This research study was conducted using an observational design to evaluate the impact of an implemented pain protocol involving acetaminophen and dexmedetomidine in the review of records of 264 cardiac surgery patients. The charts of patients who received the pain protocol were reviewed and compared to those who did not receive the protocol by conducting a retrospective, chart review. The charts were reviewed comparing the control group, which received cardiac surgery prior to the implementation of the new pain protocol, with the experimental group, which received cardiac surgery during the alternative pain protocol implementation. This study determined that patients who received the alternative pain protocol involving dexmedetomidine and acetaminophen, required a significantly lower number of opioids in the operating room (p