Jones James Harvey, Grant Stuart Alan
University of California, Berkeley, CA, USA.
Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Local Reg Anesth. 2025 Aug 27;18:77-86. doi: 10.2147/LRA.S538162. eCollection 2025.
The influence of nerve blocks on treatment bias, a form of implicit bias where patient characteristics lead to inequal treatment, remains unexplored.
This was a pilot study that utilized a survey to collect data from nurses at a single academic medical center. The following information was collected from the respondents: age (years); gender (male, female, other); nursing experience (years); specialization (surgery, medicine, emergency, perioperative, other); prior formal training on pain management in patients with or without nerve blocks; and how frequently they encounter patients with nerve blocks. Hypothetical clinical scenarios were presented to investigate pain medication dosing strategies that were rated with a 3-point Likert scale (more, equal, or less medication). Impacts of various patient conditions (alcohol abuse, anxiety, depression, marijuana use, nerve block, opioid abuse, and substance abuse) on pain medication and opioid dosing strategies were further investigated with a 5-point Likert scale (ranging from strongly disagree to strongly agree).
Overall, the survey had a 32.59% response rate. Treatment bias towards patients with nerve blocks was evident in 21.43% (9/42) and 11/30 (36.67%) of respondents for pain medications and opioids, respectively.
This pilot study suggests that patients with nerve blocks may be treated differently than those without blocks, regardless of their reported pain. However, given the study's exploratory design, these findings should be interpreted as hypothesis-generating.
神经阻滞对治疗偏倚的影响尚未得到研究，治疗偏倚是一种隐性偏倚，即患者特征导致治疗不平等。
这是一项试点研究，通过调查从一家学术医疗中心的护士中收集数据。从受访者那里收集了以下信息：年龄（岁）；性别（男、女、其他）；护理经验（年）；专业（外科、内科、急诊、围手术期、其他）；是否接受过关于有或无神经阻滞患者疼痛管理的正规培训；以及他们遇到有神经阻滞患者的频率。呈现假设的临床场景以调查疼痛药物给药策略，这些策略用3点李克特量表（更多、相同或更少药物）进行评分。使用5点李克特量表（从强烈不同意到强烈同意）进一步研究各种患者情况（酒精滥用、焦虑、抑郁、大麻使用、神经阻滞、阿片类药物滥用和药物滥用）对疼痛药物和阿片类药物给药策略的影响。
总体而言，调查的回复率为32.59%。分别有21.43%（9/42）和11/30（36.67%）的受访者在疼痛药物和阿片类药物方面对有神经阻滞的患者存在治疗偏倚。
这项试点研究表明，有神经阻滞的患者可能与没有神经阻滞的患者接受不同的治疗，无论他们报告的疼痛程度如何。然而，鉴于该研究的探索性设计，这些发现应被视为产生假设。
