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Racial disparity in peripheral nerve block usage in breast reconstruction: A nationwide analysis
Peripheral nerve block (PNB) usage in plastic surgery is associated with reduction in post-operative opioid consumption and pain demonstrating benefits in breast reconstruction (BR). This retrospective study explored whether racial-ethnic disparities exist with PNB use for postoperative analgesia in...
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| Published in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2024-11, Vol.98, p.281-284 |
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| container_end_page | 284 |
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| container_title | Journal of plastic, reconstructive & aesthetic surgery |
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| creator | Dorante, Miguel I. Escobar-Domingo, Maria J. Kennedy, Dean Kim, Erin J. Lee, Bernard T. Guo, Lifei |
| description | Peripheral nerve block (PNB) usage in plastic surgery is associated with reduction in post-operative opioid consumption and pain demonstrating benefits in breast reconstruction (BR). This retrospective study explored whether racial-ethnic disparities exist with PNB use for postoperative analgesia in patients undergoing BR.
Using the American College of Surgeons National Surgical Quality Improvement Program database, women who underwent BR from 2012–2021 and received “regional” in addition to general anesthesia were included in the study. Patients without race and ethnicity data and who received other additional anesthesia were excluded. Unweighted rates of PNB use were compared between racial-ethnic groups and BR modality. Multivariate logistic regression assessed whether race and ethnicity were independently associated with receiving PNBs.
A total of 25,188 patients underwent BR and 9429 patients (37.4%) received PNB for postoperative analgesia. Patient demographics reached statistical, but not clinical, significance in age and BMI. Comorbidities were not significantly different between groups. Black patients were less likely to receive PNBs (p |
| doi_str_mv | 10.1016/j.bjps.2024.09.054 |
| format | article |
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Using the American College of Surgeons National Surgical Quality Improvement Program database, women who underwent BR from 2012–2021 and received “regional” in addition to general anesthesia were included in the study. Patients without race and ethnicity data and who received other additional anesthesia were excluded. Unweighted rates of PNB use were compared between racial-ethnic groups and BR modality. Multivariate logistic regression assessed whether race and ethnicity were independently associated with receiving PNBs.
A total of 25,188 patients underwent BR and 9429 patients (37.4%) received PNB for postoperative analgesia. Patient demographics reached statistical, but not clinical, significance in age and BMI. Comorbidities were not significantly different between groups. Black patients were less likely to receive PNBs (p < 0.001), while Asian and Other patients were more likely to receive PNBs compared to White patients (p < 0.001). Black patients were less likely to receive PNB in immediate implant-based and autologous BR, as well as delayed autologous (p < 0.05). Asian patients were more likely to receive PNB for all implant-based BR compared to White patients (p < 0.001). Ethnicity had no significant impact on receipt of PNB. As a conclusion, racial disparity exists in use of PNBs for postoperative analgesia in BR. Equitable access to PNBs should be championed to not augment baseline racial disparity in BR.</description><identifier>ISSN: 1748-6815</identifier><identifier>ISSN: 1878-0539</identifier><identifier>EISSN: 1878-0539</identifier><identifier>DOI: 10.1016/j.bjps.2024.09.054</identifier><identifier>PMID: 39317005</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adult ; Analgesia ; Breast neoplasm ; Breast reconstruction ; Ethnicity - statistics & numerical data ; Female ; Healthcare disparities ; Healthcare Disparities - ethnology ; Healthcare Disparities - statistics & numerical data ; Humans ; Mammaplasty - methods ; Middle Aged ; Nerve Block - methods ; Nerve Block - statistics & numerical data ; Pain, Postoperative - ethnology ; Pain, Postoperative - prevention & control ; Peripheral nerves ; Racial groups ; Retrospective Studies ; United States ; White People - statistics & numerical data</subject><ispartof>Journal of plastic, reconstructive & aesthetic surgery, 2024-11, Vol.98, p.281-284</ispartof><rights>2024</rights><rights>Copyright © 2024. Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c237t-53e4f6d2f05b7322916fc3e806e7e28bd4f2439e3a6f924f7b504ee775cd60423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27907,27908</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39317005$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dorante, Miguel I.</creatorcontrib><creatorcontrib>Escobar-Domingo, Maria J.</creatorcontrib><creatorcontrib>Kennedy, Dean</creatorcontrib><creatorcontrib>Kim, Erin J.</creatorcontrib><creatorcontrib>Lee, Bernard T.</creatorcontrib><creatorcontrib>Guo, Lifei</creatorcontrib><title>Racial disparity in peripheral nerve block usage in breast reconstruction: A nationwide analysis</title><title>Journal of plastic, reconstructive & aesthetic surgery</title><addtitle>J Plast Reconstr Aesthet Surg</addtitle><description>Peripheral nerve block (PNB) usage in plastic surgery is associated with reduction in post-operative opioid consumption and pain demonstrating benefits in breast reconstruction (BR). This retrospective study explored whether racial-ethnic disparities exist with PNB use for postoperative analgesia in patients undergoing BR.
Using the American College of Surgeons National Surgical Quality Improvement Program database, women who underwent BR from 2012–2021 and received “regional” in addition to general anesthesia were included in the study. Patients without race and ethnicity data and who received other additional anesthesia were excluded. Unweighted rates of PNB use were compared between racial-ethnic groups and BR modality. Multivariate logistic regression assessed whether race and ethnicity were independently associated with receiving PNBs.
A total of 25,188 patients underwent BR and 9429 patients (37.4%) received PNB for postoperative analgesia. Patient demographics reached statistical, but not clinical, significance in age and BMI. Comorbidities were not significantly different between groups. Black patients were less likely to receive PNBs (p < 0.001), while Asian and Other patients were more likely to receive PNBs compared to White patients (p < 0.001). Black patients were less likely to receive PNB in immediate implant-based and autologous BR, as well as delayed autologous (p < 0.05). Asian patients were more likely to receive PNB for all implant-based BR compared to White patients (p < 0.001). Ethnicity had no significant impact on receipt of PNB. As a conclusion, racial disparity exists in use of PNBs for postoperative analgesia in BR. Equitable access to PNBs should be championed to not augment baseline racial disparity in BR.</description><subject>Adult</subject><subject>Analgesia</subject><subject>Breast neoplasm</subject><subject>Breast reconstruction</subject><subject>Ethnicity - statistics & numerical data</subject><subject>Female</subject><subject>Healthcare disparities</subject><subject>Healthcare Disparities - ethnology</subject><subject>Healthcare Disparities - statistics & numerical data</subject><subject>Humans</subject><subject>Mammaplasty - methods</subject><subject>Middle Aged</subject><subject>Nerve Block - methods</subject><subject>Nerve Block - statistics & numerical data</subject><subject>Pain, Postoperative - ethnology</subject><subject>Pain, Postoperative - prevention & control</subject><subject>Peripheral nerves</subject><subject>Racial groups</subject><subject>Retrospective Studies</subject><subject>United States</subject><subject>White People - statistics & numerical data</subject><issn>1748-6815</issn><issn>1878-0539</issn><issn>1878-0539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kEtLxTAQhYMovv-AC8nSTevk1bTiRsQXCILoOqbpVHPtbWvSKvff23LVpas5zJxzYD5CjhikDFh2ukjLRR9TDlymUKSg5AbZZbnOE1Ci2Jy0lnmS5UztkL0YFwBSMKm2yY4oBNMAape8PFrnbUMrH3sb_LCivqU9Bt-_YZj2LYZPpGXTuXc6RvuK870MaONAA7qujUMY3eC79oxe0NbO6stXSG1rm1X08YBs1baJePgz98nz9dXT5W1y_3Bzd3lxnzgu9JAogbLOKl6DKrXgvGBZ7QTmkKFGnpeVrLkUBQqb1QWXtS4VSEStlasykFzsk5N1bx-6jxHjYJY-Omwa22I3RiMYFJIzpcRk5WurC12MAWvTB7-0YWUYmJmsWZiZrJnJGijMRHYKHf_0j-USq7_IL8rJcL424PTlp8dgovPYOqz8BGowVef_6_8G25KK5Q</recordid><startdate>202411</startdate><enddate>202411</enddate><creator>Dorante, Miguel I.</creator><creator>Escobar-Domingo, Maria J.</creator><creator>Kennedy, Dean</creator><creator>Kim, Erin J.</creator><creator>Lee, Bernard T.</creator><creator>Guo, Lifei</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202411</creationdate><title>Racial disparity in peripheral nerve block usage in breast reconstruction: A nationwide analysis</title><author>Dorante, Miguel I. ; Escobar-Domingo, Maria J. ; Kennedy, Dean ; Kim, Erin J. ; Lee, Bernard T. ; Guo, Lifei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c237t-53e4f6d2f05b7322916fc3e806e7e28bd4f2439e3a6f924f7b504ee775cd60423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Analgesia</topic><topic>Breast neoplasm</topic><topic>Breast reconstruction</topic><topic>Ethnicity - statistics & numerical data</topic><topic>Female</topic><topic>Healthcare disparities</topic><topic>Healthcare Disparities - ethnology</topic><topic>Healthcare Disparities - statistics & numerical data</topic><topic>Humans</topic><topic>Mammaplasty - methods</topic><topic>Middle Aged</topic><topic>Nerve Block - methods</topic><topic>Nerve Block - statistics & numerical data</topic><topic>Pain, Postoperative - ethnology</topic><topic>Pain, Postoperative - prevention & control</topic><topic>Peripheral nerves</topic><topic>Racial groups</topic><topic>Retrospective Studies</topic><topic>United States</topic><topic>White People - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dorante, Miguel I.</creatorcontrib><creatorcontrib>Escobar-Domingo, Maria J.</creatorcontrib><creatorcontrib>Kennedy, Dean</creatorcontrib><creatorcontrib>Kim, Erin J.</creatorcontrib><creatorcontrib>Lee, Bernard T.</creatorcontrib><creatorcontrib>Guo, Lifei</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dorante, Miguel I.</au><au>Escobar-Domingo, Maria J.</au><au>Kennedy, Dean</au><au>Kim, Erin J.</au><au>Lee, Bernard T.</au><au>Guo, Lifei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Racial disparity in peripheral nerve block usage in breast reconstruction: A nationwide analysis</atitle><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle><addtitle>J Plast Reconstr Aesthet Surg</addtitle><date>2024-11</date><risdate>2024</risdate><volume>98</volume><spage>281</spage><epage>284</epage><pages>281-284</pages><issn>1748-6815</issn><issn>1878-0539</issn><eissn>1878-0539</eissn><abstract>Peripheral nerve block (PNB) usage in plastic surgery is associated with reduction in post-operative opioid consumption and pain demonstrating benefits in breast reconstruction (BR). This retrospective study explored whether racial-ethnic disparities exist with PNB use for postoperative analgesia in patients undergoing BR.
Using the American College of Surgeons National Surgical Quality Improvement Program database, women who underwent BR from 2012–2021 and received “regional” in addition to general anesthesia were included in the study. Patients without race and ethnicity data and who received other additional anesthesia were excluded. Unweighted rates of PNB use were compared between racial-ethnic groups and BR modality. Multivariate logistic regression assessed whether race and ethnicity were independently associated with receiving PNBs.
A total of 25,188 patients underwent BR and 9429 patients (37.4%) received PNB for postoperative analgesia. Patient demographics reached statistical, but not clinical, significance in age and BMI. Comorbidities were not significantly different between groups. Black patients were less likely to receive PNBs (p < 0.001), while Asian and Other patients were more likely to receive PNBs compared to White patients (p < 0.001). Black patients were less likely to receive PNB in immediate implant-based and autologous BR, as well as delayed autologous (p < 0.05). Asian patients were more likely to receive PNB for all implant-based BR compared to White patients (p < 0.001). Ethnicity had no significant impact on receipt of PNB. As a conclusion, racial disparity exists in use of PNBs for postoperative analgesia in BR. Equitable access to PNBs should be championed to not augment baseline racial disparity in BR.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>39317005</pmid><doi>10.1016/j.bjps.2024.09.054</doi><tpages>4</tpages></addata></record> |
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| source | ScienceDirect Freedom Collection |
| subjects | Adult Analgesia Breast neoplasm Breast reconstruction Ethnicity - statistics & numerical data Female Healthcare disparities Healthcare Disparities - ethnology Healthcare Disparities - statistics & numerical data Humans Mammaplasty - methods Middle Aged Nerve Block - methods Nerve Block - statistics & numerical data Pain, Postoperative - ethnology Pain, Postoperative - prevention & control Peripheral nerves Racial groups Retrospective Studies United States White People - statistics & numerical data |
| title | Racial disparity in peripheral nerve block usage in breast reconstruction: A nationwide analysis |
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