Date of Award

Spring 4-19-2024

Document Type


Degree Name

Doctor of Nursing Practice (DNP)




Kirk Hummer

First Committee Member

Brian Garrett

Second Committee Member

Joy Shoemaker


Ketamine, Dexmedetomidine, Lidocaine, Non-opioid Analgesia, Pain, Spine Surgery

Subject Categories

Medicine and Health Sciences


The most common cause of adult disability is chronic back pain. As medication maintenance therapy becomes ineffective, surgical intervention is the last resort for treatment. Patients with chronic pain often rely on pain medication such as opioids for relief. The exposure and dependency of opioids can create unique challenges for anesthesia providers to deliver safe and adequate anesthesia for surgery. Patient’s dependent on chronic opioids develops many adverse effects including sleep disordered breathing, suppression of the immune system, and higher risk of developing cardiovascular events under stress. There is a lack of consistent perioperative guidelines for patients undergoing spinal surgery with or without opioid exposure. This doctoral project seeks to develop evidence-based practice guidelines for perioperative management for patients undergoing spinal surgery. The Johns Hopkins evidence-based practice model was utilized to develop this doctoral project and to analyze the impact of non-opioid analgesia on visual analogue scale (VAS) scores, postoperative opioid consumption, and length of stay in the hospital (LOS). The non-opioid perioperative analgesic medications include ketamine, lidocaine, and dexmedetomidine. The project includes a plan for implementing the evidence-based practice guidelines, preparation and training staff, measuring outcomes, and potential revisions to the guidelines if there are undesirable effects.

Acknowledgement 1


Acknowledgement 2


Licensing Permission

Copyright, all rights reserved. Fair Use



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