AANA December 2021 Journal Course: Alpha-2 Adrenergic Agonist, An Attractive but Underutilized ERAS Component in Improving Fast Track Recovery and Surgical Outcomes

AANA December 2021 Journal Course: Alpha-2 Adrenergic Agonist, An Attractive but Underutilized ERAS Component in Improving Fast Track Recovery and Surgical Outcomes is organized by American Association of Nurse Anesthesiology (AANA).

Course Launch Date: 12/7/21
Course Expires: 12/6/24

Description:
Enhanced Recovery After Surgery (ERAS) protocols have been implemented in many institutions to attenuate 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 ?2-adrenergic receptor (?2-AR) agonists that can greatly enhance various ERAS components owing to their unique pharmacologic properties: antinocicep¬tion, anxiolysis, anti-inflammation, and renal protection. The ?2-AR agonists exert supraspinal and spinal antinociceptive effects by potentiating descending pain modulatory pathways and inhibiting peripheral C fibers. These antinociceptive effects of ?2-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 ?2-AR agonists decrease opioid consumption and side effects in adult and pediatric surgical patients. Given the wide distribution of ?2-ARs in the body, ?2-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 ?2-AR agonists and provides emerging evidence to support their utility in acute pain management and ERAS protocols. Perioperative administration of ?2-AR agonists can enhance pain management, decrease adverse effects, and promote surgical recovery.

Learning Outcome(s):

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