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Updated: Dec 16, 2025
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Association Between Race and Ethnicity with Intraoperative Analgesic Administration and Initial Recovery Room Pain
Christine G Jette1, Julia M Rosenbloom2, Ellen Wang1
1Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, USA.
Insights
Children received similar intraoperative opioid doses regardless of race or ethnicity. However, some racial and ethnic groups were less likely to receive non-opioid analgesics, and Asians reported less severe pain upon awakening.
Area of Science:
- Pediatric Anesthesiology
- Health Disparities Research
- Pain Management
Background:
- Perioperative pain can negatively impact patient outcomes.
- Understanding racial and ethnic disparities in pediatric pain management is crucial.
Purpose of the Study:
- To investigate disparities in perioperative pain management among children.
- To determine if specific racial and ethnic groups face increased risks of inadequate pain control.
Main Methods:
- Retrospective review of medical records for 21,229 pediatric anesthetics (≤18 years) from May 2014 to May 2018.
- Primary outcome: intraoperative morphine equivalents. Secondary outcomes: non-opioid analgesic use and pain scores upon awakening.
- Statistical analysis using regression models adjusted for confounders, with Bonferroni corrections for multiple comparisons.
Main Results:
- No significant differences in intraoperative opioid administration were found across racial and ethnic groups compared to non-Hispanic whites.
- Asians, Hispanics, and Pacific Islanders had lower odds of receiving non-opioid analgesics.
- Asians were less likely to report moderate-to-severe pain upon awakening.
Conclusions:
- While intraoperative opioid doses were similar across groups, disparities exist in non-opioid analgesic administration.
- Further research is needed to understand how these differences influence pediatric patient outcomes.
- Investigating patient, provider, and system factors is essential to address identified disparities.
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.
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