Role of CRNAs in Pain Management Included in Final CDC Clinical Practice Guidelines

AANA comments included in final CDC Guidelines for Prescribing Opioids

Rosemont, Ill. (AANA) – The American Association of Nurse Anesthesiology (AANA) applauds the Centers for Disease Control and Prevention (CDC) for providing more flexibility and clarity in their updated Clinical Practice Guidelines for Prescribing Opioids. The final guidelines include acknowledgment of the role of Certified Registered Nurse Anesthetists (CRNAs) as pain care providers, how pain care is administered, and the consideration for nonopioid therapies for subacute and chronic pain.

The 2022 Clinical Practice Guideline updates and expands the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain and provides evidence-based recommendations for providers who administer pain care, including those prescribing opioids, for outpatients age 18 years and older with: acute pain (duration less than 1 month), subacute pain (duration of 1-3 months), or chronic pain. The AANA commented on the proposed guidelines in spring 2022, requesting that the CDC acknowledge the role of CRNAs in pain management in the scope and audience section of the guideline.

The final guidelines acknowledge that advanced practice registered nurses (APRNs) such as CRNAs, in addition to physicians, manage pain. Furthermore, the final guidelines recommend that nonopioid therapies are preferred for providers, including CRNAs, treating subacute and chronic pain and should maximize the use of nonpharmacologic and nonopioid pharmacologic therapies as appropriate for the specific condition and patient.

The CDC also recommended that clinicians should only consider initiating opioid therapy if expected benefits for pain and function are anticipated to outweigh risks to the patient.

“We appreciate and support the CDC acknowledging the work of APRNs and CRNAs who are uniquely skilled to provide both acute and chronic pain management in a compassionate, holistic, and patient-centered environment,” said AANA President Angela Mund, DNP, CRNA. “Many patients rely on CRNAs as their primary pain specialist, and CRNAs play an essential role in assuring that rural America has access to critical anesthesia services. CRNAs often serve as the sole anesthesia provider in rural hospitals, affording these facilities the capability to provide many necessary procedures and allowing patients to receive this important care close to home.”

Suffering from chronic and acute pain is a personal experience that, if left undertreated or mismanaged, can radically change an individual’s quality of life and impact important relationships. The AANA believes that acute and chronic pain is best treated and managed by an interdisciplinary team that actively engages with the patient to diagnose and manage their pain for improved well-being, functionality, and quality of life.