Review of Racial/Ethnic Disparities in Obstetrics-Related Anesthesia Administration and Pain Management

Abstract

While racial/ethnic disparities in maternal outcomes including mortality and severe maternal morbidity are well documented, there is limited information on disparities in obstetric anesthesia practices. This paper reviews literature on racial/ethnic disparities in peripartum anesthesia administration and postpartum pain management. Current literature demonstrates racial/ethnic disparities in several aspects of obstetric anesthesia care including neuraxial administration for vaginal labor pain, neuraxial versus general anesthesia for cesarean delivery, post neuraxial anesthesia complications, postpartum pain management and postdural puncture headache treatment practices. However, many studies are dated or have limited data from single institutions or states. More research on nation-wide racial/ethnic disparities in obstetric anesthesia is needed to understand its broader practice and management in the USA.

Plain language summary

While racial/ethnic disparities in maternal mortality and morbidity are well documented, there is limited information on disparities in anesthesia practices for pregnant women. Consequently, this paper reviews literature on racial/ethnic disparities in maternal pain management during and after delivery. Current literature demonstrates racial/ethnic disparities in several aspects of obstetric pain management care including epidural use for vaginal labor pain, regional versus general anesthesia for cesarean delivery, epidural anesthesia complications, pain management after delivery and postural puncture headache treatment practices. However, many available studies are dated or limited to single institutions or states. Therefore, more research on nation-wide racial/ethnic disparities in obstetric pain management is needed to understand its broader practice and management in the USA.

Keywords::

• analgesia
• anesthesia
• opioids
• pain
• pain assessment
• pain management

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/pmt-2023-0034

Author contributions

Concept & design: E Khusid, R White. Drafting of the manuscript: E Khusid, R White. Critical revision of the manuscript for important intellectual content: E Khusid, B Lui, R White, A Ibarra, K Villegas. Administrative support and supervision: R White

Acknowledgments

Thank you Weill Cornell Medicine Office of Student Research for supporting medical student research endeavors.

Financial & competing interests disclosure

R White is the recipient the Foundation for Anesthesia Education and Research (FAER) grant. The two-year, $250,000 grant supports Dr White’s research into the effect of implementing Enhanced Recovery After Surgery (ERAS) protocols on delivery outcomes, and the development of a data-driven dashboard for clinicians. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

R White is the recipient the Foundation for Anesthesia Education and Research (FAER) grant. The two-year, $250,000 grant supports Dr White’s research into the effect of implementing Enhanced Recovery After Surgery (ERAS) protocols on delivery outcomes, and the development of a data-driven dashboard for clinicians. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.