Study Uncovers Disparities in Post-Surgical Pain Management for Black Patients

Black patients recovering from major surgery are less likely to receive multimodal analgesia, a pain management approach proven to reduce opioid dependence, according to new research presented at the ANESTHESIOLOGY 2024 annual meeting in Philadelphia. The study reveals that Black patients are 29% less likely than their white counterparts to receive multimodal analgesia, which utilizes various medications to improve pain control while reducing opioid use. Experts noted that this approach has been particularly effective after complex surgeries, such as lung or abdominal cancer procedures and hernia repairs.

In addition to this disparity, the research found that Black patients were 74% more likely to be prescribed oral opioids in combination with intravenous (IV) opioids compared to white patients, despite the known risks of opioid addiction. “We know that multimodal analgesia provides more effective pain management with less need for opioids, which are highly addictive. It should be standard practice, especially in high-risk surgical patients,” said Dr. Niloufar Masoudi, lead author of the study and anesthesiologist at Johns Hopkins University.

The study examined the pain management of 2,460 white patients and 482 Black patients during the first 24 hours following high-risk surgeries between 2016 and 2021. Researchers ruled out variables such as insurance, health conditions, and age, identifying significant racial disparities in pain treatment. While most patients received IV opioids, Black patients were significantly more likely to receive additional oral opioids.

Dr. Masoudi emphasized that the causes of these disparities could include patient preferences, differences in reported pain, or practitioner bias. She called for more research to uncover the exact reasons and for further studies across other ethnic groups to determine if they face similar issues.

“Pain specialists need to understand the benefits of multimodal analgesia, recognize the existence of disparities in its use, and develop standardized protocols to ensure all patients receive this preferred form of pain management when medically appropriate,” Dr. Masoudi said.

During the five-day conference, experts also discussed the critical issue of medication errors in perioperative settings. Dr. Elizabeth Rebello of the Anderson Cancer Center highlighted distractions, inadequate training, and fatigue as significant contributors to these errors. She noted that communication and teamwork, combined with smart pumps and barcoding technology, can help reduce errors.

“Implementing non-punitive reporting systems and fostering a culture of safety are key to preventing medication errors,” Dr. Rebello stated.

As the medical community continues to address these disparities and challenges, Dr. Masoudi stressed, “We must do more to ensure equitable treatment for all patients. Every patient deserves the highest standard of care, regardless of race.”