The Impact of Race on Analgesia Use among Pediatric Emergency Department Patients

A limited evaluation of the association of race and anesthetic medication administration: A single‐center experience with appendectomies

“…Goyal and colleagues showed that, among children diagnosed with appendicitis, Black patients were significantly less likely to receive opioid analgesia in the emergency room than White patients . Other studies of emergency room practice have demonstrated that Black children were significantly less likely to receive any analgesia or opioid medications for abdominal pain and were significantly less likely to receive opioids for ‘potentially painful conditions …”

“…We included only Black and White children because the numbers in all other individual racial categories in our dataset were small; combining them would be a false representation of each group's distinct experience. This restriction is not uncommon: several studies on disparities in pediatric healthcare have also limited analysis to Black and White children …”

“…3 Other studies of emergency room practice have demonstrated that Black children were significantly less likely to receive any analgesia or opioid medications for abdominal pain and were significantly less likely to receive opioids for 'potentially painful conditions. 9,17 On the other hand, one single-institution study demonstrated no difference in rates of conscious sedation between Black and White children undergoing forearm fracture reduction in the emergency room. 18 Likewise, Johnson and colleagues demonstrated that there was no significant difference in analgesic administration between White and non-White patients during air medical transport after adjustment for covariates such as systolic blood pressure and intravenous or intraosseous access.…”

Addressing the Differences by Race in Analgesia Use among Pediatric Patients Attending Emergency Departments

“…17 Pletcher et al found Whites were more likely than African American, Hispanic, and Asian/other patients to receive opioids during pain related visits to emergency rooms. 4 However, Rasooly et al focus exclusively on pediatric patients (<19) and analgesia use in emergency departments with similar findings to Pletcher et al 15 Nonetheless, the data have some limitations. Variables related to provider experience, health literacy of the patient and parents, and provider characteristics (race, sex, etc) might help better explain the disparate opioid use for pain in pediatrics.…”

“…14 In this issue of The Journal, Rasooly et al examined the relationship between race and the administration of any analgesia vs opioid analgesia to pediatric patients during emergency room visits. 15 The authors performed a secondary analysis of data from the 2005-2010 National Ambulatory Care Survey. The sample consisted of 27 183 emergency room visits of patients <19 years of age.…”