Gamboa Jakob E, Nofal Sarah S, Pattee Jack, Guess Marsha K, Clavijo Claudia F
Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO.
Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO.
J Perianesth Nurs. 2025 Jun;40(3):544-549. doi: 10.1016/j.jopan.2024.06.111. Epub 2024 Sep 19.
To determine if language-based disparities in postoperative pain management exist in women undergoing gynecologic surgery.
A retrospective cohort study was performed.
The electronic medical records were reviewed of individuals, aged 18 to 80, who underwent an abdominal hysterectomy between 2016 and 2021 at the University of Colorado Anschutz Medical Center. A random sample of 100 patients, 50 categorized as English proficient and 50 categorized as having limited English proficiency (LEP), were compared. The primary outcomes were the number of quantitative pain assessments and the total dose of opioid given in oral morphine milligram equivalents. The secondary outcomes were the average pain scores, the number of qualitative pain assessments, postanesthesia care unit length of stay, regional block use, patient-controlled analgesia, or opioid use after the first 24 hours. Linear and generalized linear modeling was used to assess the relationship between English proficiency and the outcomes of interest.
All patients received at least 1 pain assessment while in the postanesthesia care unit (range 2 to 25). There was no significant difference in the number of objective pain assessments or the total dose of opioid given between the groups. There were no significant differences in any of the secondary outcomes between the groups. On subgroup analysis, the presence of a documented bedside interpreter did not result in a significant difference in endpoints. Fewer LEP patients received patient-controlled analgesia (34% LEP vs 58% English proficient), though the difference did not reach statistical significance.
Language barriers may complicate care and impact postoperative recovery. In our population of women in a high-volume, urban, level I, trauma center, there were no observed differences in postoperative pain management practices in patients with LEP compared with English-proficient patients. Standardized nursing protocols may contribute to more equitable care. Ongoing investigations in the identification and prevention of language-related disparities in perioperative care are warranted.
确定接受妇科手术的女性在术后疼痛管理方面是否存在基于语言的差异。
进行了一项回顾性队列研究。
回顾了2016年至2021年在科罗拉多大学安舒茨医学中心接受腹部子宫切除术的18至80岁个体的电子病历。比较了100名患者的随机样本，其中50名被归类为英语熟练，50名被归类为英语水平有限（LEP）。主要结局是定量疼痛评估的次数和以口服吗啡毫克当量计算的阿片类药物总剂量。次要结局是平均疼痛评分、定性疼痛评估的次数、麻醉后护理单元住院时间、区域阻滞的使用、患者自控镇痛或术后24小时后的阿片类药物使用情况。使用线性和广义线性模型来评估英语水平与感兴趣的结局之间的关系。
所有患者在麻醉后护理单元期间至少接受了1次疼痛评估（范围为2至25次）。两组之间客观疼痛评估的次数或给予的阿片类药物总剂量没有显著差异。两组之间的任何次要结局均无显著差异。在亚组分析中，有记录的床边口译员的存在并未导致终点有显著差异。接受患者自控镇痛的LEP患者较少（34%的LEP患者 vs 58%的英语熟练患者），尽管差异未达到统计学显著性。
语言障碍可能会使护理复杂化并影响术后恢复。在我们这个位于大城市、一级创伤中心的大量女性人群中，与英语熟练的患者相比，未观察到LEP患者在术后疼痛管理实践方面存在差异。标准化的护理方案可能有助于实现更公平的护理。有必要对围手术期护理中与语言相关的差异的识别和预防进行持续调查。
