Al-Hashimi Mhamad, Scott Simon, Griffin-Teall Nicola, Thompson Jonathan
Department of Anaesthesia, University Hospitals of Leicester NHS Trust, Leicester, UK.
The Hope Clinical Unit, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK.
Br J Pain. 2015 Aug;9(3):167-72. doi: 10.1177/2049463714559254.
Previous studies indicated that patients from Black, Asian and minority ethnic (BAME) groups tend to receive less analgesics compared to Caucasian (White) patients after similar surgical procedures. Most such data originated from North America and suggested that health-care professionals may perceive the expression of excessive pain by BAME patient groups as an exaggerated response to pain, rather than sub-optimal treatment. There are limited data comparing acute pain management between South Asian and White British patients.
We aimed to investigate correlation between patients' ethnicity and disparities of early post-operative pain perception/management, in an ethnically diverse population.
We conducted a retrospective case note review of acute post-operative pain after total abdominal hysterectomy (TAH) in 60 South Asian and 60 age-matched White British females. Data for 140 variables (pre-, intra- and post-operative) for each patient were recorded. We used propensity score matching to produce 30 closely matched patients in each group minimizing effects of recorded co-variates. Data were analysed with and without propensity score matching.
There were no significant differences in acute post-operative pain scores, morphine requirements, pain management, adverse effects or duration of post-operative care unit stay between South Asian and White British patients. The median duration of hospital stay of South Asian patients was longer (4.5 days versus 3.0 days, p < 0.001).
We conclude that in an institution where both patients and health-care professionals are from an ethnically diverse population, neither post-operative pain nor pain management are influenced significantly by South Asian ethnicity.
先前的研究表明,与白种人患者相比,来自黑人、亚洲人和少数族裔(BAME)群体的患者在接受类似外科手术后往往接受较少的镇痛药。大多数此类数据来自北美,表明医疗保健专业人员可能将BAME患者群体过度疼痛的表达视为对疼痛的夸大反应,而非治疗不足。比较南亚患者和英国白人患者急性疼痛管理的资料有限。
我们旨在调查不同种族人群中患者种族与术后早期疼痛感知/管理差异之间的相关性。
我们对60名南亚女性和60名年龄匹配的英国白人女性全腹子宫切除术后的急性术后疼痛进行了回顾性病例记录审查。记录了每位患者140个变量(术前、术中和术后)的数据。我们使用倾向评分匹配法在每组中产生30对匹配紧密的患者,以尽量减少记录的协变量的影响。对有无倾向评分匹配的数据进行了分析。
南亚患者和英国白人患者在术后急性疼痛评分、吗啡需求量、疼痛管理、不良反应或术后护理单元住院时间方面无显著差异。南亚患者的中位住院时间较长(4.5天对3.0天,p<0.001)。
我们得出结论,在一个患者和医疗保健专业人员都来自不同种族人群的机构中,南亚种族对术后疼痛和疼痛管理均无显著影响。