As medical professionals, we hope that we are not consciously biased with regard to race or skin color. Each patient needs to be treated as an individual. However, there are real ethnical and racial differences in patient experiences, expectations, and response to therapy. The differences are likely a combination of both cultural and biological (e.g., genetic) racial and ethnic differences.
Dr. Sylvia H. Wilson, Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC and colleagues prospectively evaluated racial and ethnic differences as they relate to the timing of neuraxial analgesia for cervical dilation. The results of their study are published in this month’s issue of Anesthesia & Analgesia in the article titled “A Prospective Observational Study of Ethnic and Racial Differences in Neuraxial Labor Analgesia Request and Pain Relief.”
Three hundred ninety-seven parturients were enrolled in the study. The primary outcome was cervical dilation at the time of a request for neuraxial analgesia. Ethnicity and race were self-defined. The 397 parturients self-identified into four ethnicity/race categories: 51 Hispanic, 161 African American, 168 non-Hispanic White, and 17 other (Asian, Indian, Native American, Portuguese, and Filipino). Cervical dilation and numeric pain scale scores at the time of request did not vary according to ethnicity/race.
Parturients whose education was higher, who were nulliparous, who required labor augmentation, and who underwent operative delivery requested neuraxial analgesia when their cervix was less dilated. Although the average difference in pain scores of Hispanic parturients after initiation of neuraxial analgesia was higher, this difference was not clinically significant and turned out not to be a factor when a multivariate model was used to determine factors known to impact a request for neuraxial labor analgesia.
This study evaluates racial and ethnic disparities in neuraxial analgesia, an important yet understudied area of obstetric anesthesia.