Forero Juan Pablo, Sun Eric C, Mariano Edward R, Dixit Anjali A
Department of Anesthesiology, Perioperative and Pain Medicine; Stanford University School of Medicine; Stanford, CA, USA.
Department of Health Policy; Stanford University School of Medicine; Stanford, CA, USA.
Curr Anesthesiol Rep. 2025;15(1). doi: 10.1007/s40140-024-00676-3. Epub 2024 Dec 26.
High-quality evidence substantiates the use of regional anesthesia for elective total joint arthroplasty. The use of regional anesthesia in this surgical population, therefore, can also be used to evaluate health care disparities and measure health equity. This narrative review assesses and summarizes available literature on disparities in the use of regional anesthesia for total joint arthroplasty and identifies factors contributing to those disparities.
We found that disparities exist in the use of regional anesthesia for total joint arthroplasty and are multifactorial in origin, encompassing patient characteristics such as race and ethnicity and systemic factors such as hospital type and insurance status. However, there is an overall paucity of literature focused specifically on drivers of disparities, and no evidence supporting interventions that may alleviate known disparities.
Disparities in use of regional anesthesia for total joint arthroplasty are multifactorial in origin and encompass differences in care at the levels of race, ethnicity, hospital, and insurance status, among others. Additional work is needed at the epidemiologic level to understand what factors underlie known disparities in anesthesia care and how best to promote health equity for surgical patients undergoing this set of procedures.
高质量证据证实了区域麻醉在择期全关节置换术中的应用。因此，在这一手术人群中使用区域麻醉也可用于评估医疗保健差异并衡量健康公平性。本叙述性综述评估并总结了关于全关节置换术中区域麻醉使用差异的现有文献，并确定了导致这些差异的因素。
我们发现全关节置换术中区域麻醉的使用存在差异，其起源是多因素的，包括种族和民族等患者特征以及医院类型和保险状况等系统因素。然而，总体而言，专门关注差异驱动因素的文献很少，也没有证据支持可能缓解已知差异的干预措施。
全关节置换术中区域麻醉使用的差异起源是多因素的，包括种族、民族、医院和保险状况等层面的护理差异等。在流行病学层面需要开展更多工作，以了解麻醉护理中已知差异背后的因素，以及如何最好地促进接受这类手术的患者的健康公平性。
