Disparities Among Women, Minorities, and Patients in Medicaid Found in the Distribution of Regional Anesthesia

A study presented at the Anesthesiology 2022 annual meeting reports that women, minorities, and patients enrolled in Medicaid are less likely to receive regional anesthesia, which reduces pain after surgery. The team used data from more than 56,000 patients to conduct the first study that reports such disparities in anesthesia provision in patients having one of the seven common surgeries.

Regional anesthesia is drugs injected to numb the lower part of the body and the nerve area where the surgery is being performed. A catheter may sometimes be placed near the nerve as the anesthesia is delivered for a few days after surgery.

(Photo : Unsplash/Alexander Grey)
Disparities Among Women, Minorities, and Patients in Medicaid Found in the Distribution of Regional Anesthesia

Regional Anesthesia Explained

According to the American Society of Anesthesiologists, regional anesthesia numbs a large area of the body that is delivered through an injection or small tube when a simple injection of local anesthetic is not enough and when it is better if the patient is awake.

Regional anesthesia, such as spinal blocks and epidurals, are often used for childbirth. For instance, an epidural is the most common type of pain management for labor and delivery as it allows the mother to be awake to be able to push when it is time to deliver the baby and at the same time numbs the pain.

Another type is the spinal block, which is stronger and is used during cesarean deliveries (C-sections). Both spinal block and epidurals allow the doctor to surgically deliver the baby without pain and without subjecting the baby to harmful sedating drugs.

This type of anesthesia is very safe and does not involve potential complications and side effects that may happen during general anesthesia and sedation. However, regional anesthesia does carry some risks and the patient must be monitored by an anesthesiologist.

They are professionals who work with the surgical team to evaluate, monitor and supervise the patient's care before, during, and after surgery. They deliver the drug, leading the Anesthesia Care Team, and ensure the optimal safety of the patient.

The Disparity in Delivering Equitable Anesthesia

Alex Beletsky, M.D., the lead author of the study presented at this year's annual meeting for anesthesiologists and resident anesthesiologists at Riverside Community Hospital in California, admitted that there are many things to do in delivering equitable anesthesia care.

He also pointed out some factors that may contribute to the ongoing disparity. Medical Xpress reported that this includes patients being less inclined to receive regional anesthesia less consistently because of practice trends at a specific hospital or surgical center, or individual surgeons or preferences on anesthesiologists.

The team reviewed records of over 56,000 patients 18 years old and above who had surgery between January 2016 and June 2021 in one of the seven common surgeries. These are the main findings from their study:

Patients with Medicaid insurance were 39% less likely to receive regional anesthesia compared to those with private anesthesia.
Minorities were 29% less likely to receive regional anesthesia than white patients.
Those with medical conditions were likely 12% less likely to receive regional anesthesia compared to those with less-severe conditions
Female patients were 11% less likely to receive regional anesthesia than their male counterparts.

The study sets a framework for future research to understand why such disparities among groups of people happen and determine how to improve access to this valuable care.