Related Experiment Video
Updated: Sep 21, 2025
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Association of Race and Ethnicity with Pediatric Postoperative Pain Outcomes
Julia M Rosenbloom1, Elizabeth De Souza1, Felipe D Perez1
1Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Insights
Asian children experienced less postoperative pain and opioid use compared to White non-Hispanic children. These racial disparities in pediatric pain management require further investigation into cultural and healthcare provider factors.
Area of Science:
- Pediatric Anesthesiology
- Health Services Research
- Health Equity
Background:
- Inequitable healthcare practices can lead to disparities in patient outcomes.
- Children of color may experience variations in perioperative analgesic administration and subsequent outcomes.
Purpose of the Study:
- To investigate the association between race/ethnicity and perioperative pain management in children.
- To determine if racial and ethnic disparities exist in pain scores and opioid administration among pediatric patients.
Main Methods:
- Retrospective review of medical records for 29,614 children aged 0-18 years (May 2014 - August 2019).
- Exposure: Race/ethnicity (Asian, Black, Hispanic, Pacific Islander, White non-Hispanic).
- Outcomes: Post-anesthesia care unit (PACU) and inpatient pain scores, opioid, antiemetic, and antipruritic administration, analyzed using multilevel logistic regression.
Main Results:
- Asian children had lower odds of receiving opioids and experiencing moderate-severe pain in both PACU and inpatient settings compared to White non-Hispanic children.
- Black, Hispanic, and Pacific Islander children showed no significant difference in opioid use or moderate-severe pain compared to White non-Hispanic children.
Conclusions:
- Asian children experienced significantly lower rates of postoperative pain and opioid administration compared to White non-Hispanic children.
- Observed disparities may stem from patient/caregiver cultural factors or variations in healthcare provider practices, necessitating further research.
Introduction:
Inequitable variability in healthcare practice negatively affects patient outcomes. Children of color may receive different analgesic medications in the perioperative period, resulting in different outcomes.
Methods:
Medical records of children 0 to ≤ 18 years old from May 2014 to August 2019 were reviewed. The exposure was racial or ethnic groups: Asian, Black, Hispanic, Pacific Islander, and White non-Hispanic (reference).
Primary Outcome:
post-anesthesia care unit mean pain score.
Secondary Outcomes:
inpatient mean pain score; opioid, antiemetic, and antipruritic administration in the post-anesthesia care unit and inpatient ward. The association of race or ethnicity with outcomes was modeled using multilevel logistic regression, adjusting for confounders and covariates.
Results:
Twenty-nine thousand six hundred fourteen cases are included. In the post-anesthesia care unit, Black, Hispanic, and Pacific Islander children had no significant difference in the odds of receiving opioids or having moderate-severe pain as compared to White non-Hispanic patients; Asian children had lower odds of receiving opioids and lower odds of having a moderate-severe mean pain score. In the inpatient setting, Black, Hispanic, and Pacific Islander children had no significant difference in the odds of receiving opioids or having moderate severe-pain as compared to White non-Hispanic children, but Asian children had lower odds of receiving opioids and of having a moderate-severe mean pain score.
Conclusions:
Asian children had lower odds of receiving opioids and having moderate-severe pain postoperatively compared to the White non-Hispanic children. These differences may be a function of variation in patient/caregivers culture or healthcare provider care and warrant further investigation.
Related Concept Videos
02:16Surveys
01:23Peripheral Artery Disease V: Postoperative Nursing Management
02:55Stereotypes, Prejudice, and Discrimination
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:25Analgesia and Pain Management