Julia M Rosenbloom1,2, Kumaran Senthil3, Alexander S Long4, Whitney R Robinson5,6, Kenneth N Peeples7, John E Fiadjoe7,8, Ronald S Litman7,8. 1. Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA. 2. Harvard Medical School, Boston, MA, USA. 3. Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. 4. Department of Statistics, North Carolina State University, Raleigh, NC, USA. 5. Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 6. Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 7. Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. 8. Perelman School of Medicine, University of Philadelphia, Philadelphia, PA, USA.
Abstract
BACKGROUND: Although it is known that a patient's race may influence their medical care, racial patterns of medication administration in pediatric anesthesia have not been well-studied. The aim of this study was to determine if differences exist between Black and White children with regard to administration of anesthetic and analgesic medications for a single procedure at our institution. METHODS: We conducted a retrospective review of medications administered to patients for emergency appendectomies at a large academic children's hospital from 2010 to 2015. We examined the association between patient race and administration of preoperative midazolam and intraoperative ondansetron, lidocaine, ketorolac, and weight-based doses of fentanyl and morphine. RESULTS: During the study period, 1680 patients (1329 White, 351 Black) underwent emergency appendectomy. There were no significant racial differences in administration of intraoperative anesthetic medications between Black and White children. In unadjusted analysis, Black children were less likely to receive preoperative midazolam than White children (OR=0.74 [95% CI, 0.58-0.94], P=.012). After adjusting for confounders, there was no evidence of racial differences in administration of preoperative or intraoperative medications. CONCLUSION: We did not find a significant difference in preoperative or intraoperative medication administration based on race when we adjusted for age, gender, and attending anesthesiologist practice patterns. We encourage all institutions to monitor their own practice patterns with regard to race.
BACKGROUND: Although it is known that a patient's race may influence their medical care, racial patterns of medication administration in pediatric anesthesia have not been well-studied. The aim of this study was to determine if differences exist between Black and White children with regard to administration of anesthetic and analgesic medications for a single procedure at our institution. METHODS: We conducted a retrospective review of medications administered to patients for emergency appendectomies at a large academic children's hospital from 2010 to 2015. We examined the association between patient race and administration of preoperative midazolam and intraoperative ondansetron, lidocaine, ketorolac, and weight-based doses of fentanyl and morphine. RESULTS: During the study period, 1680 patients (1329 White, 351 Black) underwent emergency appendectomy. There were no significant racial differences in administration of intraoperative anesthetic medications between Black and White children. In unadjusted analysis, Black children were less likely to receive preoperative midazolam than White children (OR=0.74 [95% CI, 0.58-0.94], P=.012). After adjusting for confounders, there was no evidence of racial differences in administration of preoperative or intraoperative medications. CONCLUSION: We did not find a significant difference in preoperative or intraoperative medication administration based on race when we adjusted for age, gender, and attending anesthesiologist practice patterns. We encourage all institutions to monitor their own practice patterns with regard to race.
Authors: Michael R King; Elizabeth De Souza; Julia M Rosenbloom; Ellen Wang; T Anthony Anderson Journal: Anesth Analg Date: 2020-07 Impact factor: 5.108
Authors: JoAnne E Natale; Lisa A Asaro; Jill G Joseph; Christine Ulysse; Judith Ascenzi; Cindy Bowens; David Wypij; Martha A Q Curley Journal: Ann Am Thorac Soc Date: 2021-01
Authors: Christine G Jette; Julia M Rosenbloom; Ellen Wang; Elizabeth De Souza; T Anthony Anderson Journal: J Racial Ethn Health Disparities Date: 2020-07-03