Race, ethnicity, and the use of regional anesthesia in cancer patients undergoing open abdominal surgery: A single-center retrospective cohort study

BackgroundWhere applicable, regional anesthesia has been shown to be superior to opioid or non-opioid analgesic modalities alone. However, some studies have shown ethnic-based disparities in the use of regional anesthesia in patients undergoing surgical procedures. In this study of patients who had...

Full description

Bibliographic Details
Main Authors: Pascal Owusu-Agyemang, Lei Feng, Vivian H. Porche, Uduak U. Williams, Juan P. Cata
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-08-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2022.950444/full
_version_ 1828286014347542528
author Pascal Owusu-Agyemang
Pascal Owusu-Agyemang
Lei Feng
Vivian H. Porche
Uduak U. Williams
Juan P. Cata
Juan P. Cata
author_facet Pascal Owusu-Agyemang
Pascal Owusu-Agyemang
Lei Feng
Vivian H. Porche
Uduak U. Williams
Juan P. Cata
Juan P. Cata
author_sort Pascal Owusu-Agyemang
collection DOAJ
description BackgroundWhere applicable, regional anesthesia has been shown to be superior to opioid or non-opioid analgesic modalities alone. However, some studies have shown ethnic-based disparities in the use of regional anesthesia in patients undergoing surgical procedures. In this study of patients who had undergone major oncologic surgery, our main objective was to compare the use of regional anesthesia between patients of different ethnicities.MethodsA retrospective review of adults who had undergone major open abdominal surgical procedures between 2016 and 2021 was performed. Logistic regression models were used to assess the association between baseline patient characteristics and the use of regional anesthesia.ResultsA total of 4,791 patients were included in the analysis. The median age was 60.5 years [interquartile range, 49, 69], the majority were female (65%), and of American Society of Anesthesiologists Physical Status Class (ASA) 3 (94.7%). Regional anesthesia was used in 2,652 patients (55.4%) and was not associated with race or ethnicity (p = 0.287). Compared to White patients, the odds of regional anesthesia use in other racial/ethnic groups were: Asian {odds ratio (OR) 0.851 [95% confidence interval (CI), 0.660–1.097]; p = 0.2125}, Black/African American [OR 0.807 (95% CI, 0.651–1.001); p = 0.0508], Hispanic/Latino [OR 0.957 (95% CI, 0.824–1.154); p = 0.7676], Other race [OR 0.957 (95% CI, 0.627–1.461); p = 0.8376]. In the multivariable analysis, age [OR 0.995 (95% CI, 0.991–1.000); p = 0.0309] and female gender [OR 1.231 (95% CI, 1.090–1.390); p = 0.0008] were associated with the use of regional anesthesia.ConclusionIn this single-institution retrospective study of adults who had undergone major open abdominal surgery, the use of regional anesthesia was not associated with race or ethnicity. In the multivariable analysis, age and female gender were associated with the use of regional anesthesia.
first_indexed 2024-04-13T09:24:24Z
format Article
id doaj.art-69a97d2d068f407ab3360bade7aeb0f4
institution Directory Open Access Journal
issn 2296-858X
language English
last_indexed 2024-04-13T09:24:24Z
publishDate 2022-08-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj.art-69a97d2d068f407ab3360bade7aeb0f42022-12-22T02:52:29ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-08-01910.3389/fmed.2022.950444950444Race, ethnicity, and the use of regional anesthesia in cancer patients undergoing open abdominal surgery: A single-center retrospective cohort studyPascal Owusu-Agyemang0Pascal Owusu-Agyemang1Lei Feng2Vivian H. Porche3Uduak U. Williams4Juan P. Cata5Juan P. Cata6Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesAnesthesiology and Surgical Oncology Research Group, Houston, TX, United StatesDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesAnesthesiology and Surgical Oncology Research Group, Houston, TX, United StatesBackgroundWhere applicable, regional anesthesia has been shown to be superior to opioid or non-opioid analgesic modalities alone. However, some studies have shown ethnic-based disparities in the use of regional anesthesia in patients undergoing surgical procedures. In this study of patients who had undergone major oncologic surgery, our main objective was to compare the use of regional anesthesia between patients of different ethnicities.MethodsA retrospective review of adults who had undergone major open abdominal surgical procedures between 2016 and 2021 was performed. Logistic regression models were used to assess the association between baseline patient characteristics and the use of regional anesthesia.ResultsA total of 4,791 patients were included in the analysis. The median age was 60.5 years [interquartile range, 49, 69], the majority were female (65%), and of American Society of Anesthesiologists Physical Status Class (ASA) 3 (94.7%). Regional anesthesia was used in 2,652 patients (55.4%) and was not associated with race or ethnicity (p = 0.287). Compared to White patients, the odds of regional anesthesia use in other racial/ethnic groups were: Asian {odds ratio (OR) 0.851 [95% confidence interval (CI), 0.660–1.097]; p = 0.2125}, Black/African American [OR 0.807 (95% CI, 0.651–1.001); p = 0.0508], Hispanic/Latino [OR 0.957 (95% CI, 0.824–1.154); p = 0.7676], Other race [OR 0.957 (95% CI, 0.627–1.461); p = 0.8376]. In the multivariable analysis, age [OR 0.995 (95% CI, 0.991–1.000); p = 0.0309] and female gender [OR 1.231 (95% CI, 1.090–1.390); p = 0.0008] were associated with the use of regional anesthesia.ConclusionIn this single-institution retrospective study of adults who had undergone major open abdominal surgery, the use of regional anesthesia was not associated with race or ethnicity. In the multivariable analysis, age and female gender were associated with the use of regional anesthesia.https://www.frontiersin.org/articles/10.3389/fmed.2022.950444/fullregional anesthesia (RA)raceethnicitypostoperative painopioids
spellingShingle Pascal Owusu-Agyemang
Pascal Owusu-Agyemang
Lei Feng
Vivian H. Porche
Uduak U. Williams
Juan P. Cata
Juan P. Cata
Race, ethnicity, and the use of regional anesthesia in cancer patients undergoing open abdominal surgery: A single-center retrospective cohort study
Frontiers in Medicine
regional anesthesia (RA)
race
ethnicity
postoperative pain
opioids
title Race, ethnicity, and the use of regional anesthesia in cancer patients undergoing open abdominal surgery: A single-center retrospective cohort study
title_full Race, ethnicity, and the use of regional anesthesia in cancer patients undergoing open abdominal surgery: A single-center retrospective cohort study
title_fullStr Race, ethnicity, and the use of regional anesthesia in cancer patients undergoing open abdominal surgery: A single-center retrospective cohort study
title_full_unstemmed Race, ethnicity, and the use of regional anesthesia in cancer patients undergoing open abdominal surgery: A single-center retrospective cohort study
title_short Race, ethnicity, and the use of regional anesthesia in cancer patients undergoing open abdominal surgery: A single-center retrospective cohort study
title_sort race ethnicity and the use of regional anesthesia in cancer patients undergoing open abdominal surgery a single center retrospective cohort study
topic regional anesthesia (RA)
race
ethnicity
postoperative pain
opioids
url https://www.frontiersin.org/articles/10.3389/fmed.2022.950444/full
work_keys_str_mv AT pascalowusuagyemang raceethnicityandtheuseofregionalanesthesiaincancerpatientsundergoingopenabdominalsurgeryasinglecenterretrospectivecohortstudy
AT pascalowusuagyemang raceethnicityandtheuseofregionalanesthesiaincancerpatientsundergoingopenabdominalsurgeryasinglecenterretrospectivecohortstudy
AT leifeng raceethnicityandtheuseofregionalanesthesiaincancerpatientsundergoingopenabdominalsurgeryasinglecenterretrospectivecohortstudy
AT vivianhporche raceethnicityandtheuseofregionalanesthesiaincancerpatientsundergoingopenabdominalsurgeryasinglecenterretrospectivecohortstudy
AT uduakuwilliams raceethnicityandtheuseofregionalanesthesiaincancerpatientsundergoingopenabdominalsurgeryasinglecenterretrospectivecohortstudy
AT juanpcata raceethnicityandtheuseofregionalanesthesiaincancerpatientsundergoingopenabdominalsurgeryasinglecenterretrospectivecohortstudy
AT juanpcata raceethnicityandtheuseofregionalanesthesiaincancerpatientsundergoingopenabdominalsurgeryasinglecenterretrospectivecohortstudy