Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School/Brigham & Women's Hospital, Boston, Massachusetts.
Division of Regional Anesthesia, Department of Anesthesiology, University of California San Diego, San Diego, California.
J Arthroplasty. 2023 Sep;38(9):1663-1667. doi: 10.1016/j.arth.2023.03.032. Epub 2023 Mar 15.
There is an increasing body of evidence that suggests racial and ethnic disparities exist in medical care. In the field of anesthesiology, few studies have investigated the association of race and ethnicity with the provision of regional anesthesia for patients undergoing total knee arthroplasty. This analysis queried a large national surgical database to determine whether there were racial or ethnic differences in the administration of peripheral nerve blocks for patients undergoing total knee arthroplasty.
In this retrospective cohort study, data were collected from a large national database during the years 2017-2019. Multivariable logistic regressions were used to measure the association of race and ethnicity with utilization of regional anesthesia. The participants for the study were patients 18 years or older undergoing total knee arthroplasty.
Our primary finding was that among patients undergoing total knee arthroplasty, Black patients had lower odds (adjusted odds ratio [aOR]: 0.93, 99% confidence interval [CI]: 0.89-0.98) of receiving regional anesthesia than White patients. Also, Hispanic patients had lower odds (aOR: 0.88, 99% CI: 0.83-0.94) of receiving regional anesthesia than non-Hispanic patients. Native Hawaiian/Pacific Islander patients had increased odds (aOR: 2.04, 99% CI: 1.66-2.51) of receiving regional anesthesia.
This study demonstrated that there might be racial and ethnic differences in the provision of regional anesthesia for patients undergoing total knee arthroplasty. These differences underscore the need for more studies aimed at equitable access to high quality and culturally competent health care.
越来越多的证据表明，医疗保健中存在种族和民族差异。在麻醉学领域，很少有研究调查种族和民族与接受全膝关节置换术的患者接受区域麻醉之间的关联。本分析调查了一个大型国家手术数据库，以确定在接受全膝关节置换术的患者中，给予周围神经阻滞是否存在种族或民族差异。
在这项回顾性队列研究中，数据来自 2017 年至 2019 年期间的一个大型国家数据库。多变量逻辑回归用于衡量种族和民族与区域麻醉使用率的关联。该研究的参与者为接受全膝关节置换术的 18 岁或以上的患者。
我们的主要发现是，在接受全膝关节置换术的患者中，黑人患者接受区域麻醉的可能性低于白人患者（调整后的优势比 [aOR]：0.93，99%置信区间 [CI]：0.89-0.98）。此外，西班牙裔患者接受区域麻醉的可能性低于非西班牙裔患者（aOR：0.88，99% CI：0.83-0.94）。夏威夷原住民/太平洋岛民患者接受区域麻醉的可能性增加（aOR：2.04，99% CI：1.66-2.51）。
本研究表明，在接受全膝关节置换术的患者中，区域麻醉的提供可能存在种族和民族差异。这些差异强调需要进行更多旨在公平获得高质量和文化上胜任的医疗保健的研究。
