Abstract
Purpose
Optimal postoperative pain management remains a significant problem despite the availability
of multiple preoperative, intraoperative, and postoperative pain management interventions.
Recent studies suggest that racialized minorities, female sex, and individuals of
lower socioeconomic status (SES) are more likely to experience more severe pain and
inadequate pain management postoperatively. Our systematic review aimed to determine
race, sex, and SES differences in postoperative pain and postoperative pain management.
Design
This study is a systematic review of literature.
Methods
Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
methodology, we systematically searched 5 databases: Cumulative Index to Nursing and
Allied Health Literature (CINAHL), PubMed, Embase, Scopus, and Cochrane. We included
primary source peer-reviewed articles published after 1990 that measured postoperative
pain and race/ethnicity, sex/gender, or SES, which were published in English. Two
pairs of reviewers independently screened each title, abstract, and article for inclusion.
In cases of disagreement, a third reviewer broke the tie.
Findings
A total of 464 articles were screened, of which 32 were included in this study. In
most studies, Blacks/African American experience more severe postoperative pain than
Whites/Caucasians. Whites were more likely to be prescribed opioids for pain management
than Blacks, Hispanics, and Asians. Also, individuals of lower SES and females reported
more postoperative pain. One study found no race/ethnic group differences in pain
scores and opioid use after the implementation of the enhanced recovery after surgery
(ERAS) protocol.
Conclusion
Optimal postoperative pain relief continues to be a challenge for individuals who
self-identify as racialized minorities, females, and those of lower SES. Standardization
of care may help reduce disparities in postoperative pain management.
Keywords
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Article info
Publication history
Published online: December 01, 2022
Publication stage
In Press Corrected ProofFootnotes
Conflict of interest: None to report.
Identification
Copyright
© 2022 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.
