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Jette CG, Rosenbloom JM, Wang E, et al. Association Between Race and Ethnicity with Intraoperative Analgesic Administration and Initial Recovery Room Pain Scores in Pediatric Patients: a Single-Center Study of 21,229 Surgeries. J Racial Ethn Health Disparities. 2020;8(3):547-558doi: 10.1007/s40615-020-00811-w.
Jette, C. G., Rosenbloom, J. M., Wang, E., De Souza, E., & Anderson, T. A. (2021). Association Between Race and Ethnicity with Intraoperative Analgesic Administration and Initial Recovery Room Pain Scores in Pediatric Patients: a Single-Center Study of 21,229 Surgeries. Journal of racial and ethnic health disparities, 8(3), 547-558. https://doi.org/10.1007/s40615-020-00811-w
Jette, Christine G, et al. "Association Between Race and Ethnicity with Intraoperative Analgesic Administration and Initial Recovery Room Pain Scores in Pediatric Patients: a Single-Center Study of 21,229 Surgeries." Journal of racial and ethnic health disparities vol. 8,3 (2021): 547-558. doi: https://doi.org/10.1007/s40615-020-00811-w
Jette CG, Rosenbloom JM, Wang E, De Souza E, Anderson TA. Association Between Race and Ethnicity with Intraoperative Analgesic Administration and Initial Recovery Room Pain Scores in Pediatric Patients: a Single-Center Study of 21,229 Surgeries. J Racial Ethn Health Disparities. 2021 Jun;8(3):547-558. doi: 10.1007/s40615-020-00811-w. Epub 2020 Jul 03. PMID: 32621098; PMCID: PMC8629166.
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J Racial Ethn Health Disparities. 2021 Jun;8(3):547-558. doi: 10.1007/s40615-020-00811-w. Epub 2020 Jul 03.

Association Between Race and Ethnicity with Intraoperative Analgesic Administration and Initial Recovery Room Pain Scores in Pediatric Patients: a Single-Center Study of 21,229 Surgeries.

Journal of racial and ethnic health disparities

Christine G Jette, Julia M Rosenbloom, Ellen Wang, Elizabeth De Souza, T Anthony Anderson

Affiliations

  1. Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, USA.
  2. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  3. Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, USA. [email protected].

PMID: 32621098 PMCID: PMC8629166 DOI: 10.1007/s40615-020-00811-w

Abstract

INTRODUCTION: Perioperative pain may have deleterious effects for all patients. We aim to examine disparities in pain management for children in the perioperative period to understand whether any racial and ethnic groups are at increased risk of poor pain control.

METHODS: Medical records from children ≤ 18 years of age who underwent surgery from May 2014 to May 2018 were reviewed. The primary outcome was total intraoperative morphine equivalents. The secondary outcomes were intraoperative non-opioid analgesic administration and first conscious pain score. The exposure was race and ethnicity. The associations of race and ethnicity with outcomes of interest were modeled using linear or logistic regression, adjusted for preselected confounders and covariates. Bonferroni corrections were made for multiple comparisons.

RESULTS: A total of 21,229 anesthetics were included in analyses. In the adjusted analysis, no racial and ethnic group received significantly more or less opioids intraoperatively than non-Hispanic (NH) whites. Asians, Hispanics, and Pacific Islanders were estimated to have significantly lower odds of receiving non-opioid analgesics than NH whites: odds ratio (OR) = 0.83 (95% confidence interval (CI): 0.70, 0.97); OR = 0.84 (95% CI: 0.74, 0.97), and OR = 0.53 (95% CI: 0.33, 0.84) respectively. Asians were estimated to have significantly lower odds of reporting moderate-to-severe pain on awakening than NH whites: OR = 0.80 (95% CI: 0.66, 0.99).

CONCLUSIONS: Although children of all races and ethnicities investigated received similar total intraoperative opioid doses, some were less likely to receive non-opioid analgesics intraoperatively. Asians were less likely to report moderate-severe pain upon awakening. Further investigation may delineate how these differences lead to disparate patient outcomes and are influenced by patient, provider, and system factors.

Keywords: Healthcare disparities; Pediatric anesthesia; Perioperative analgesia; Race and ethnicity

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