Racial and ethnic differences in acute post-operative pain management: Systematic review and meta-analysis - 05/06/25
, Erik J. Feldtmann b, Carlos Bellido b, Emily C. Coughlin b, Rahul S. Mhaskar b, Cameron R. Smith c, B. Lee Green d, Linda T. Le-Wendling cAbstract |
Background |
There are significant racial and ethnic differences in healthcare outcomes, including pain treatment.
Objectives |
We conducted a systematic review and meta-analysis to investigate the racial and ethnic differences in acute pain treatment of surgical patients.
Methods |
We searched PubMed, Embase, and Scopus databases for any studies that reported racial and ethnic minority groups and treating acute postoperative pain. Random-effect meta-analysis was used to compare the odds ratio of receipt of regional anesthesia among racial and ethnic groups.
Results |
Non-White patients were 18 % less likely to have regional anesthesia for postoperative pain [OR 0.82 (95 % CI; 0.76, 0.9]. Racial minority groups had lower rates of regional anesthesia—Black patients with OR of 0.93 (95 % CI; 0.91, 0.95); Asian patients with OR of 0.84 (95 % CI; 0.81, 0.87); race indicated as Other with OR of 0.78 (95 % CI; 0.71, 0.86). Only 3 studies reported Native Hawaiian and Alaska Native groups and found higher rates of regional anesthesia. Hispanic patients were 20 % less likely to receive regional anesthesia [OR of 0.8 (95 % CI; 0.72, 0.87)].
Three studies found some differences in opioid administration associated with race and ethnicity. A formal meta-analysis was not possible because of the heterogeneity of follow-up and timepoint comparison.
Conclusion |
There are racial and ethnic differences in the treatment of acute pain, especially in receipt of regional anesthesia. The most important step forward is the appropriate reporting of racial and ethnic demographic information. Further studies are warranted to understand the process by which differences arise in acute pain management.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Current evidence demonstrates that: Non-White patients are 18 % less likely to receive regional anesthesia compared to White patients. |
• | Hispanic patients 20 % less likely to receive regional anesthesia compared to non-Hispanic patients. |
• | Black patients are 7 % less likely and Asian patients are 6 % less likely, to receive regional anesthesia when compared to White patients. |
• | Patients with race indicated as Other are 12 % less likely to receive regional anesthesia when compared to White patients. |
• | These findings highlight a need for regional resources, practices, and systems changes for equitable access to perioperative care for all patients. |
Keywords : Regional anesthesia, Racial disparities, Racial differences, Ethnic disparities, Ethnic differences, Acute pain, Opioids
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Vol 104
Article 111858- juin 2025 Retour au numéro
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