Kratom Use: An Emerging Perioperative Nursing Concern

Kratom is an emerging drug of concern that poses significant challenges in perioperative care, but the public and many health professionals remain unaware of its use and effects. Patients may use kratom as a substitute for opioids or to increase focus or decrease anxiety, depending on the dose. Kratom binds with μ-opioid, α₂-adrenergic, and serotonin receptors and has been associated with perioperative complications, including difficulty managing pain, hemodynamic instability, agitation, and withdrawal symptoms in patients undergoing surgery. Considering that 1.9 million Americans aged 12 years and older have used kratom, screening patients before surgery is important. Preoperative nurses can positively affect patient care by communicating a patient's use of kratom to the care team. With that knowledge, perianesthesia, intraoperative, and postoperative teams can be prepared for any untoward effects of kratom use across all perioperative settings.