Racial and ethnic differences in acute post-operative pain management: Systematic review and meta-analysis

IF 5 2区医学 Q1 ANESTHESIOLOGY

Journal of Clinical Anesthesia Pub Date : 2025-05-05 DOI:10.1016/j.jclinane.2025.111858

Anastasia Jones , Erik J. Feldtmann , Carlos Bellido , Emily C. Coughlin , Rahul S. Mhaskar , Cameron R. Smith , B. Lee Green , Linda T. Le-Wendling

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Abstract

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.

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急性术后疼痛管理的种族差异：系统回顾和荟萃分析

在包括疼痛治疗在内的医疗保健结果上存在显著的种族和民族差异。目的通过系统回顾和荟萃分析，探讨手术患者急性疼痛治疗的种族差异。方法检索PubMed、Embase和Scopus数据库，查找有关少数族裔群体和治疗急性术后疼痛的研究。采用随机效应荟萃分析比较不同种族和民族接受区域麻醉的优势比。结果非白人患者术后疼痛采用区域麻醉的可能性降低18% [OR 0.82 (95% CI；0.76、0.9)。少数种族组区域麻醉发生率较低——黑人患者OR为0.93 (95% CI；0.91、0.95);亚洲患者OR为0.84 (95% CI；0.81、0.87);人种为Other， OR为0.78 (95% CI；0.71, 0.86)。只有3项研究报告了夏威夷原住民和阿拉斯加原住民群体，并发现了更高的区域麻醉率。西班牙裔患者接受区域麻醉的可能性降低20% [OR为0.8 (95% CI；0.72, 0.87)]。三项研究发现，阿片类药物的使用与种族有关。由于随访和时间点比较的异质性，不可能进行正式的荟萃分析。结论急性疼痛的治疗存在种族和民族差异，尤其是区域麻醉的治疗。向前迈出的最重要的一步是适当报告种族和族裔人口信息。进一步的研究是必要的，以了解在急性疼痛管理中产生差异的过程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Anesthesia 医学-麻醉学

CiteScore

7.40

自引率

4.50%

发文量

346

审稿时长

23 days

期刊介绍： The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.