Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 2;13(1):114.
doi: 10.1186/s13741-024-00473-w.

Opioid administration across racial and ethnic groups for patients undergoing liver resection: are there disparities?

Blaine Stannard  1 , Allen Ninh  2 , Victoria Mroz  3 , Yuxia Ouyang  3   4 , Natalia N Egorova  4 , Samuel DeMaria Jr  3 , Ryan Wang  3
Affiliations

Opioid administration across racial and ethnic groups for patients undergoing liver resection: are there disparities?

Blaine Stannard et al. Perioper Med (Lond). .

Abstract

Background: Racial and ethnic disparities in the treatment of perioperative pain have not been well-studied, despite being observed in a variety of other medical settings. The goal of this investigation was to evaluate the relationship between race and ethnicity and intra- and postoperative opioid administration for patients undergoing open liver resection surgery.

Methods: In this single-center retrospective cohort study, adult patients undergoing open liver resection from January 2012 to May 2019 were identified. Demographic, intraoperative, and postoperative data were extracted from the institutional perioperative data warehouse. The primary outcome was weight-based intraoperative morphine milligram equivalents (MME/kg). Secondary outcome variables included use of neuraxial analgesia and length of stay (LOS). Multivariable regression models were used, which controlled for pertinent factors such as age and duration of surgery.

Results: There were 1294 adult open liver resections included in this study: 532 (41%) patients self-reported as White, 401 (31%) as Asian, 159 (12%) as Black, 97 (7%) as Hispanic, and 105 (8%) as Other. The risk adjusted mean intraoperative MME/kg was not different among racial groups (White: 3.25 [95% CL 3.02-3.49] mg/kg vs. Asian: 3.38 [95% CL 3.10-3.69] mg/kg, p = 0.87; Black: 2.95 [95% CL 2.70-3.23] mg/kg, p = 0.19; Hispanic: 3.36 [95% CL 3.00-3.77] mg/kg, p = 0.97). In the multivariable models for secondary outcomes, length of stay was significantly higher for Black (estimate: 1.17, CL: 1.00 to 1.35, p = 0.047) and Hispanic (1.30, CL: 1.05 to 1.65, p = 0.018) patients relative to White patients. No racial/ethnic groups were significantly associated with higher or lower odds of receiving regional anesthesia.

Conclusions: For patients undergoing liver resection surgery, no racial and ethnic disparities were observed for weight-based intraoperative MME.

Keywords: Acute pain; Disparities; Equity; Hepatobiliary; Pain management.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: This single-center retrospective cohort study was approved by the Program for the Protection of Human Subjects at our institution with a waiver of written consent: IRB# 19–01166-CR001. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Patient selection diagram
See this image and copyright information in PMC

References

    1. Ahn H, Weaver M, Lyon D, Kim J, Choi E, Staud R, et al. Differences in clinical pain and experimental pain sensitivity between Asian Americans and Whites with knee osteoarthritis. Clin J Pain. 2017;33(2):174–80. - PMC - PubMed
    1. Anderson KO, Green CR, Payne R. Racial and ethnic disparities in pain: causes and consequences of unequal care. J Pain. 2009;10(12):1187–204. - PubMed
    1. Buchanan R, Roy N, Parra MF, Staffa SJ, Brown ML, Nasr VG. Race and outcomes in patients with congenital cardiac disease in an enhanced recovery program. J Cardiothorac Vasc Anesth. 2022;36(9):3603–9. - PubMed
    1. Felder L, Cao CD, Konys C, Weerasooriya N, Mercier R, Berghella V, et al. Enhanced recovery after surgery protocol to improve racial and ethnic disparities in postcesarean pain management. Am J Perinatol. 2022;39(13):1375–82. - PubMed
    1. Gebre M, Kenlyn EK, Boorman DW, Jones A, Lynde G, Woodbury A. Racial and sex disparities in opioid administration under anesthesia. J Pain Manage. 2023;16(1):55–65.

LinkOut - more resources