Anesthesia Care for Patients Undergoing Total Joint Arthroplasty: A Narrative Review of Disparities in Regional Anesthesia and Recommendations for Future Research Directions.
Juan Pablo Forero, Eric C Sun, Edward R Mariano, Anjali A Dixit
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Abstract
Purpose of review: High-quality evidence substantiates the use of regional anesthesia for elective total joint arthroplasty. The use of regional anesthesia in this surgical population, therefore, can also be used to evaluate health care disparities and measure health equity. This narrative review assesses and summarizes available literature on disparities in the use of regional anesthesia for total joint arthroplasty and identifies factors contributing to those disparities.
Recent findings: We found that disparities exist in the use of regional anesthesia for total joint arthroplasty and are multifactorial in origin, encompassing patient characteristics such as race and ethnicity and systemic factors such as hospital type and insurance status. However, there is an overall paucity of literature focused specifically on drivers of disparities, and no evidence supporting interventions that may alleviate known disparities.
Summary: Disparities in use of regional anesthesia for total joint arthroplasty are multifactorial in origin and encompass differences in care at the levels of race, ethnicity, hospital, and insurance status, among others. Additional work is needed at the epidemiologic level to understand what factors underlie known disparities in anesthesia care and how best to promote health equity for surgical patients undergoing this set of procedures.
期刊介绍：
This journal aims to offer expert review articles on the most significant recent developments in the field of anesthesiology. By providing clear, insightful, balanced contributions, the journal intends to serve those involved in the delivery of anesthesia for surgical and medical procedures, treatment of acute and chronic pain conditions, perioperative management for operative and intensive care unit patients, and associated basic science and clinical research efforts in their areas. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An Editorial Board of more than 20 internationally diverse members reviews the annual table of contents, ensures that topics include emerging research, and suggests topics of special importance to their country/region. Topics covered may include ambulatory anesthesia; anesthesia and inflammation; anesthetic mechanisms; anesthetic pharmacology; cardiovascular anesthesia; critical care anesthesia; local anesthetic pharmacology; monitoring technology; neuroanesthesia; neuromuscular blockade; obstetrical anesthesia; pain mechanisms; pain therapy; patient safety; pediatric anesthesia; quality assessment; regional anesthesia; and transplantation anesthesia.
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