Racial and ethnic disparities in both healthcare management and delivery have been extensively documented in medical literature. For example, patients from non-White minority backgrounds in the United States have been found to experience worse clinical outcomes after surgery, to receive fewer surgical procedures, and to experience worse perioperative pain management compared with patients from non-minority backgrounds. A recent NIH-ACS Symposium on Surgical Disparities Research has identified an urgent need for research aimed at addressing and understanding these disparities. The present review summarizes existing literature describing perioperative pain disparities in children in the United States, as well as highlights the paucity of research in this domain. Specifically, there is a need for randomized control trials and health services research studying pediatric perioperative pain disparities. A multidisciplinary systems-based approach would help translate findings from scientific research to clinical practice and is a crucial step to ensuring all children of diverse backgrounds receive optimal perioperative care.
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http://dx.doi.org/10.1111/pan.14557 | DOI Listing |
Trials
January 2025
Department of Neurology, Universitätsmedizin Greifswald, Fleischmannstraße 6, Greifswald, 17489, Germany.
Background: Postoperative delirium (POD) is the most common neurological adverse event among elderly patients undergoing surgery. POD is associated with an increased risk for postoperative complications, long-term cognitive decline, an increase in morbidity and mortality as well as extended hospital stays. Delirium prevention and treatment options are currently limited.
View Article and Find Full Text PDFBr J Anaesth
January 2025
Department of Theatres, Anaesthesia and Perioperative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK; Faculty of Life Sciences and Medicine, King's College London, London, UK.
Total knee arthroplasty is a life-changing surgical procedure that is associated with a high incidence of severe postoperative pain. Key to enhancing recovery after surgery is effective analgesia and early mobilisation. Innovations in motor-sparing regional anaesthesia techniques that have improved recovery include targeted surgical local infiltration analgesia, adductor canal blockade, genicular nerve blocks, and the infiltration between the popliteal artery and posterior capsule of the knee (iPACK) block.
View Article and Find Full Text PDFBr J Anaesth
January 2025
Population Health Research Institute, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada.
Background: Optimised use of kidney function information might improve cardiac risk prediction in noncardiac surgery.
Methods: In 35,815 patients from the VISION cohort study and 9219 patients from the POISE-2 trial who were ≥45 yr old and underwent nonurgent inpatient noncardiac surgery, we examined (by age and sex) the association between continuous nonlinear preoperative estimated glomerular filtration rate (eGFR) and the composite of myocardial injury after noncardiac surgery, nonfatal cardiac arrest, or death owing to a cardiac cause within 30 days after surgery. We estimated contributions of predictive information, C-statistic, and net benefit from eGFR and other common patient and surgical characteristics to large multivariable models.
J Knee Surg
January 2025
Department of Orthopedic Surgery, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Dongjak-gu, Korea (the Republic of).
Purpose The purpose of this study was to evaluate whether IV dexamethasone, within the current multimodal pain management protocol, (1) could maintain postoperative pain at a comparable level without IV PCA, (2) could reduce opioids-related side effects, and (3) whether an additional dose of dexamethasone on POD 2 would offer further pain-relieving effect without increasing the risk of complications. Methods A total of 178 patients (182 knees) who underwent total knee arthroplasty (TKA) for osteoarthritis were included in the study. The patients were divided into Dexa 2 & PCA and Dexa 3 & NoPCA group.
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