• Posted October 21, 2024

Doctors More Likely to Order 'Opioids Only' for Black Patients After Surgery

After Black patients undergo a surgery, they are much more likely than their white peers to receive only an opioid for post-op pain relief, rather than a more nuanced combo of analgesics, a new study finds.

So-called "multimodal analgesia" is the recommended way to go, experts say, but Black patients are 29% less likely to receive it.

“We know that multimodal analgesia provides more effective pain management with less need for opioids, which are highly addictive. It should be standard practice, especially in high-risk surgical patients,” explained study lead author Dr. Niloufar Masoudi, an anesthesiologist and research assistant at Johns Hopkins University, in Baltimore.

Her team presented its findings Saturday in Philadelphia at the annual meeting of the American Society of Anesthesiologists.

The researchers looked at data for 2016 through 2021 from a single hospital. They compared the post-op pain management of 2,460 white patients against that received by 482 Black patients in the intensive care unit for the first 24 hours after complex, high-risk surgeries.

Masoudi's group defined multimodal pain relief as an opioid painkiller plus at least one other form of pain medication. That might include an epidural or pain patch, an NSAID painkiller (these include drugs such as ibuprofen or naproxen), gabapentin or IV ketamine.

However, not only were Black patients nearly a third less likely to get multimodal analgesia, they were 74% more likely than white patients to get an opioid pill plus IV opioids as their pain regimen.

A number of factors might be driving this disparity, Masoudi said. Patients of different races might have differences in how much pain they report to doctors or in their personal preferences for pain medications. As well, there could be "practitioner bias for or against forms of pain management by race," according to a meeting news release.

“Further research needs to be done to understand the specific cause for the differences in multimodal analgesia between Black and white patients so recommendations can be developed," Masoudi said.

“In the meantime, pain specialists need to understand the benefits of multimodal analgesia," she added, and work to "ensure all patients receive this preferred form of pain management when medically appropriate.”

Because these findings were presented at a medical meeting, they should be considered preliminary until published in a peer-reviewed journal.

More information

There's more on options for post-surgical pain relief at the Cleveland Clinic.

SOURCE: American Society of Anesthesiologists, news release, Oct. 20, 2024