Racial Disparities in Post-Surgical Pain Management Highlighted in New Study

New research presented at the ANESTHESIOLOGY® 2024 annual meeting reveals that Black patients are less likely than white patients to receive multimodal analgesia—a combination of pain management drugs—after major surgeries. Instead, Black patients are more frequently prescribed opioids alone, which may limit the effectiveness of their post-surgical pain relief and increase their exposure to opioid-related risks.

Study Reveals Differences in Pain Management Approaches

The study examined the medical records of over 2,900 patients who underwent high-risk surgeries between 2016 and 2021. Results indicated that Black patients were 29% less likely than white patients to receive a multimodal approach involving four pain medications. Additionally, while almost all patients received intravenous (IV) opioids, Black patients were 74% more likely to also receive oral opioids. The study highlights the effectiveness of using multiple medications to control pain and potentially reduce opioid dependency but finds that Black patients are less likely to receive this approach.

Exploring the Disparity in Pain Management

Lead author Dr. Niloufar Masoudi, an anesthesiologist and research assistant at Johns Hopkins University, explained that multimodal analgesia is associated with better pain control and reduced opioid use but noted that Black patients were still more likely to receive opioids without other supportive medications. The study found no significant demographic or clinical factors—such as insurance status, age, or health conditions—that would account for the difference, suggesting other underlying causes. Researchers ruled out these common factors with “reasonable confidence,” raising questions about equity and potential bias in care delivery.

Implications for Clinical Practice

The study underscores the importance of establishing standardized protocols to ensure equitable access to multimodal analgesia across all racial and ethnic groups. As Dr. Masoudi noted, “pain specialists need to understand the benefits of multimodal analgesia, recognize the existence of disparities in its use and develop standardized protocols” to ensure that all patients receive this preferred pain management approach when appropriate. Researchers also emphasize the need for further investigation to determine the specific causes of these disparities and suggest that future studies should evaluate whether similar disparities affect other racial or ethnic groups.

This research highlights the importance of multimodal analgesia in providing effective and safer post-surgical pain relief and raises concerns about racial disparities that could affect patient outcomes. Pain management specialists are encouraged to be mindful of these findings and work toward more uniform care practices to improve pain management equity.