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Updated: Jun 27, 2025
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An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
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Exploring the relationship between language, postoperative pain, and opioid use
Rachel A Levy1, Allison H Kay2, Nancy Hills3
1Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California (Dr Levy), San Francisco, CA.
AJOG Global Reports
|April 29, 2024
Summary
Non-English speaking patients undergoing gynecologic surgery received less pain medication and fewer pain assessments postoperatively. This highlights a risk of undertreated pain and disparities in postoperative pain management for these patients.
Area of Science:
- Pain Management
- Health Disparities
- Gynecologic Oncology
Background:
- Racial and ethnic disparities in pain management are established.
- Language-based differences in postoperative pain assessment and management remain understudied in gynecologic surgery.
Purpose of the Study:
- To examine the association between patient language and immediate postoperative pain management.
- To compare pain assessments and perioperative opioid use between non-English and English speakers.
Main Methods:
- Retrospective cohort study of gynecologic oncology open surgery patients (2012-2020).
- Comparison of perioperative outcomes between non-English-speaking and English-speaking patient groups.
- Analysis of pain assessments and oral morphine equivalents (OMEs) in the postoperative period.
Main Results:
- Non-English speakers received fewer postoperative OMEs daily (31.7 vs 43.9) and less frequent pain assessments (7.7 vs 8.8 checks/day) compared to English speakers.
- English speakers received significantly more OMEs both daily in-hospital and at discharge.
- Despite similar surgical complexity, language influenced pain management intensity and frequency.
Conclusions:
- Non-English speaking patients are at risk for undertreated postoperative pain.
- Language barriers, assessment frequency, and provider bias contribute to pain management disparities.
- Regular verbal pain assessments using language-concordant staff or interpreters are recommended for all postoperative patients.
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