Recent research indicates that Black patients are less likely to receive effective pain management disparities startergies following major surgeries compared to their White counterparts. This disparity highlights significant racial inequities in healthcare delivery, particularly in the context of multimodal analgesia.
Study Overview
A study presented at the American Society of Anesthesiologists’ annual meeting in Philadelphia revealed that Black patients recovering from thoracic or abdominal surgeries were more likely to be prescribed oral opioids instead of multimodal analgesia. This pain management disparities approach employs a combination of medications to enhance pain relief and reduce reliance on opioids, which are known to be addictive. The study involved an analysis of data from surgeries conducted at Johns Hopkins Hospital between July 2016 and July 2021, focusing on 482 Black adults and 2,460 White adults.
Findings on Pain Management disparities
The analysis showed that Black patients were approximately 74% more likely to receive opioid prescriptions during their recovery. Furthermore, the likelihood of Black patients receiving multimodal analgesia—which incorporates four or more modes of pain management—was found to be 29% lower than that of White patients. Interestingly, no significant differences were observed in the administration of two or three modes of analgesia, highlighting a specific gap in the more comprehensive multimodal approach.
Implications of Multimodal Analgesia
Multimodal analgesia is recognized for its potential to not only provide better pain relief but also to mitigate the risks associated with opioid use. Dr. Nauder Faraday, a professor at Johns Hopkins University School of Medicine and co-author of the study, emphasized the importance of this method in improving patient outcomes. He suggested that patients can proactively inquire about their pain management strategies both before and after surgery to ensure they receive the most effective treatment.
Concerns Over Racial Disparities
The researchers underscored the necessity for further investigation into the racial disparities evident in pain management practices. Dr. Eli Carrillo, an emergency physician at Stanford Medicine, noted that while the study presented compelling correlations between race and pain medication administration, it did not address patient-reported pain levels. Carrillo expressed the importance of understanding whether differences in pain perception existed between racial groups, which could provide additional context to the findings.
Carrillo also pointed out that most postoperative pain management disparities systems typically include comprehensive care protocols, such as enhanced recovery after surgery (ERAS) guidelines. These protocols aim to optimize patient recovery while minimizing opioid use. Understanding whether Black patients received more opioids despite being part of these protocols could indicate systemic issues in treatment approaches.
Broader Context of Racial Inequities
The findings align with previous research highlighting systemic racism in healthcare, which often results in Black patients receiving inadequate pain management. A 2007 study found that physicians were twice as likely to underestimate pain in Black patients compared to other ethnicities. Similarly, a 2016 study revealed that many medical students and residents held false beliefs about biological differences between racial groups, contributing to disparities in pain assessment and treatment recommendations.
A survey conducted by KFF last year indicated that 15% of Black patients reported being refused pain medication they believed they required, compared to lower percentages among other racial groups. This ongoing issue of medical racism perpetuates the cycle of inadequate care for marginalized populations.
Comparative Studies on Emergency Care
In addition to disparities in post-surgery pain management, another study presented at the same conference highlighted inequities in emergency care. It revealed that Black and Brown trauma patients were less likely to receive timely helicopter transport during medical emergencies, despite the proven survival benefits of airlifting severe injury cases. Researchers noted that White patients were twice as likely to be airlifted compared to Black patients, underscoring the pervasive nature of racial disparities in healthcare.
Conclusion
The evidence presented in these studies calls for urgent systemic changes in medical practices to ensure equitable healthcare for all patients, regardless of race. Understanding and addressing the biases that contribute to these disparities is essential for improving pain management and overall patient outcomes in the healthcare system.
