Carisa Zarr

Date of Award


Document Type

Independent Study

Degree Name

Master of Science (MS)


Optimal pain management for the surgical patient is challenging for anesthesia providers. Finding new and improved methods of relieving surgical pain and evolving new techniques is an area of much research. The concept of preemptive analgesia suggests that the best postoperative pain management begins preoperatively (Morgan, Mikhail, & Murray, 2009). Preemptive administration of analgesic medications is used to stop pain from starting by blocking the nervous system's usual response to pain. This preemptive approach is thought to prevent wind up after the noxious stimulus of a surgical incision and can help prevent heightened sensitivity and lasting pain after surgery

Ketamine is an N-methyl-D-aspartate (NMDA) receptor antagonist that has undergone nwnerous studies for its preemptive administration benefits. Evidence shows that ketamine when given preemptively, intravenously or by epidural, can have a positive effect on postoperative pain. Ketamine given in small doses prior to surgical incision is shown in many studies to decrease postoperative pain, thus, decreasing narcotic requirements

The information obtained from the research on this topic was presented to both student nurse anesthetists and practicing nurse anesthetists at the North Dakota Association of Nurse Anesthetists fall meeting in Bismarck, ND. Implications for anesthesia providers and students included adding a pain relief strategy to their already growing arsenal of analgesic methods. Better pain management for surgical patients can lead to less anxiety, discomfort, stress, and earlier discharge from the hospital saving healthcare dollars (Aston, 2012).