Usage patterns of regional anesthesia for panniculectomy in the United States

Regional anesthesia (RA) reduces opioid consumption, improves postoperative pain control, and facilitates recovery. Although racial and ethnic disparities in RA use have been documented in various surgical fields, limited data exist on its use in plastic surgery and body contouring procedures. We aimed to evaluate the utilization of RA and potential disparities among patients undergoing panniculectomies. We conducted a retrospective cohort study using the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database from 2014 to 2020. Patients who underwent panniculectomies were analyzed, and adjunct peripheral nerve block use was evaluated. Multivariate logistical regression was used to evaluate associations between patient characteristics and RA usage. Among 8779 patients, 594 (6.8%) received RA for panniculectomies. Unadjusted analysis showed Black patients had significantly lower odds of receiving RA compared to White patients (OR 0.77, 95% CI 0.61-0.96, p=0.023), whereas patients classified as "Other" had higher odds (OR 2.64, 95% CI 1.50-4.62, p<0.001). After adjustment for age, sex, race, ethnicity, BMI, smoking status, diabetes, hypertension, chronic steroid use, COPD, CHF, dialysis, cancer, bleeding, and ASA class, no statistically significant differences in RA receipt for panniculectomy were observed by race or ethnicity. In this national cohort of patients undergoing abdominal body contouring surgery, no statistically significant racial or ethnic disparities in RA use were observed after adjustment. The low overall utilization of RA may suggest underuse in panniculectomies and highlights opportunities to optimize prophylactic pain management strategies for patients.