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Racial Differences in Postoperative Opioid Prescribing Practices in Spine Surgical Patients.
Letchuman, Vijay; He, Liangliang; Mummaneni, Praveen V; Agarwal, Nitin; Campbell, Liam J; Shabani, Saman; Chan, Andrew K; Abrecht, Christopher R; Miller, Catherine; Sankaran, Sujatha; Rambachan, Aksharananda; Croci, Rhiannon; Berven, Sigurd H; Chou, Dean; Holly, Langston T; Guan, Zhonghui.
Afiliação
  • Letchuman V; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • He L; Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California, USA.
  • Mummaneni PV; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Agarwal N; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Campbell LJ; Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California, USA.
  • Shabani S; Department of Medicine, University of the Incarnate Word School of Osteopathic Medicine, San Antonio, Texas, USA.
  • Chan AK; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Abrecht CR; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Miller C; Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California, USA.
  • Sankaran S; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Rambachan A; Department of Hospital Medicine, University of California, San Francisco, San Francisco, California, USA.
  • Croci R; Department of Hospital Medicine, University of California, San Francisco, San Francisco, California, USA.
  • Berven SH; Department of Health Informatics, University of California, San Francisco, San Francisco, California, USA.
  • Chou D; Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Holly LT; Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
  • Guan Z; Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, USA.
Neurosurgery ; 92(3): 490-496, 2023 03 01.
Article em En | MEDLINE | ID: mdl-36700672
ABSTRACT

BACKGROUND:

As the opioid epidemic accelerates in the United States, numerous sociodemographic factors have been implicated its development and are, furthermore, a driving factor of the disparities in postoperative pain management. Recent studies have suggested potential associations between the influence of race and ethnicity on pain perception but also the presence of unconscious biases in the treatment of pain in minority patients.

OBJECTIVE:

To characterize the perioperative opioid requirements across racial groups after spine surgery.

METHODS:

A retrospective, observational study of 1944 opioid-naive adult patients undergoing a neurosurgical spine procedure, from June 2012 to December 2019, was performed at a large, quaternary care institute. Postoperative inpatient and outpatient opioid usage was measured by oral morphine equivalents, across various racial groups.

RESULTS:

Case characteristics were similar between racial groups. In the postoperative period, White patients had shorter lengths of stay compared with Black and Asian patients ( P < .05). Asian patients used lower postoperative inpatient opioid doses in comparison with White patients ( P < .001). White patients were discharged with significantly higher doses of opioids compared with Black patients ( P < .01); however, they were less likely to be readmitted within 30 days of discharge ( P < .01).

CONCLUSION:

In a large cohort of opioid-naive postoperative neurosurgical patients, this study demonstrates higher inpatient and outpatient postoperative opioid usage among White patients. Increasing physician awareness to the effect of race on inpatient and outpatient pain management would allow for a modified opioid prescribing practice that ensures limited yet effective opioid dosages void of implicit biases.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dor Pós-Operatória / Analgésicos Opioides Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans País/Região como assunto: America do norte Idioma: En Revista: Neurosurgery Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dor Pós-Operatória / Analgésicos Opioides Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans País/Região como assunto: America do norte Idioma: En Revista: Neurosurgery Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos