CRNAs and Sugammadex Use: A Qualitative Analysis

Background: The availability of Sugammadex has increased options for Certified Registered Nurse Anesthetists’ (CRNAs) and their choice of neuromuscular reversal agents, however administration is impacted by a variety of provider and institutional factors. Objectives: The purpose of this study was to examine and describe the personal and institutional factors impacting the use of Sugammadex in Illinois by CRNAs. Method: A qualitative study design using an open-ended survey yielded 209 responses. The three main themes that emerged were 1) Why CRNAs choose to use or avoid Sugammadex 2) How CRNAs dose Sugammadex and 3) Practice variations existing within the clinical setting. Results: The most commonly reported subthemes included depth of blockade/dosing of paralytic, underlying disease pathology, size of the patient, and cost considerations or availability at their institution. Conclusion: Based upon these main themes and subthemes, it is recommended that institution wide policies be created to reduce variability in provider administration practices if Sugammadex is not widely accepted as standard reversal. Keywords: anesthesia, Sugammadex, neuromuscular blockade reversal, nurse anesthetis