Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, United States.
Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States.
J Cardiothorac Vasc Anesth. 2022 Sep;36(9):3603-3609. doi: 10.1053/j.jvca.2022.04.008. Epub 2022 Apr 20.
Disparities in perioperative outcomes exist. In addition to patient and socioeconomic factors, racial disparities in outcome measures may be related to issues at the provider and institutional levels. Recognizing a potential role of standardized care in mitigating provider bias, this study aims to compare the perioperative sedation and pain management and consequent outcomes in Enhanced Recovery After Surgery (ERAS) cardiac patients of different races undergoing congenital heart surgery at a single quaternary children's hospital.
A retrospective study.
A single quaternary pediatric hospital.
Patients, infants to adults, undergoing elective congenital cardiac surgery and enrolled in the ERAS protocol from October 2018 to December 2020.
None.
Of the patients, 872 were reviewed and 606 with race information were analyzed. There was no significant difference in intraoperative and postoperative oral morphine equivalent, perioperative sedatives, and regional blockade in Asian or African American patients when compared to White patients. Postoperative pain scores and outcomes among African American and Asian races were also not statistically different when compared to White patients.
Racial disparity in perioperative management and outcomes in patients with standardized ERAS protocols does not exist at the authors' institution. Future comparative studies of ERAS noncardiac patients may provide additional information on the role of standardization in reducing implicit bias.
手术期结局存在差异。除了患者和社会经济因素外,结局测量指标的种族差异可能与提供者和机构层面的问题有关。鉴于标准化护理在减轻提供者偏见方面可能发挥作用,本研究旨在比较在一家单一的四级儿童医院接受先天性心脏病手术的不同种族的接受强化恢复术后(ERAS)心脏患者的围手术期镇静和疼痛管理以及相应结局。
回顾性研究。
一家单一的四级儿科医院。
患者,婴儿至成人,择期接受先天性心脏手术并于 2018 年 10 月至 2020 年 12 月期间纳入 ERAS 方案。
无。
在回顾的患者中,有 872 名患者,分析了有种族信息的 606 名患者。与白人患者相比,亚洲或非裔美国患者的术中及术后口服吗啡等效物、围手术期镇静剂和区域阻滞并无显著差异。与白人患者相比,非裔美国人和亚洲种族的术后疼痛评分和结局也无统计学差异。
在作者所在机构,接受标准化 ERAS 方案的患者在围手术期管理和结局方面不存在种族差异。未来对 ERAS 非心脏患者的比较研究可能会提供更多关于标准化在减少隐性偏见方面作用的信息。