Date of Award

Fall 12-2020

Degree Type


Degree Name

Doctor of Nursing Practice (DNP)


Leadership and Advanced Nursing Practice

Committee Chair

Dr. Nina McLain

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. Mary Jane Collins

Committee Member 2 School

Leadership and Advanced Nursing Practice


Upon anesthesia induction, patients often receive fentanyl, an opioid medication that is linked to addiction, dependence, morbidity, and mortality (Stanley, 2014). The goal of this practice recommendation was to propose an alternative way of managing pain and the increased sympathetic response in the perioperative setting, specifically during the induction phase, through evaluating published research. A possible substitute for fentanyl is a drug called dexmedetomidine (Precedex™). Through a comparison of pharmacology, indications, risks, and benefits, one can conclude that if Precedex™ is given prior to induction, in the place of large doses of fentanyl, it can potentially achieve a smoother intraoperative period through promoting decreased sympathetic stimulation and a maintained respiratory drive (Gaszynski et al., 2014). The goal was to provide a literature-based, relevant practice recommendation for anesthesia providers who are open to changing their daily practice. The hope was that the recommendation will serve as a clear reference regarding the risks and benefits of dexmedetomidine, as well as the benefits and potentially detrimental side effects of fentanyl in their practice.

The proposed practice recommendation was formulated into a three-page handout that detailed the highlights of our research regarding this topic. We presented this handout via email to all CRNAs at a central Mississippi hospital. This handout was read and evaluated by willing CRNAs who subsequently completed a survey consisting of closed-ended questions. These questions inquired about relevance, availability, and willingness to adopt the practice recommendation into clinical practice.