Review of racial/ethnic disparities in obstetrics-related anesthesia administration and pain management

Pain Manag. 2023 Jul;13(7):415-422. doi: 10.2217/pmt-2023-0034. Epub 2023 Aug 11.

Abstract

While racial/ethnic disparities in maternal outcomes including mortality and severe maternal morbidity are well documented, there is limited information on disparities in obstetric anesthesia practices. This paper reviews literature on racial/ethnic disparities in peripartum anesthesia administration and postpartum pain management. Current literature demonstrates racial/ethnic disparities in several aspects of obstetric anesthesia care including neuraxial administration for vaginal labor pain, neuraxial versus general anesthesia for cesarean delivery, post neuraxial anesthesia complications, postpartum pain management and postdural puncture headache treatment practices. However, many studies are dated or have limited data from single institutions or states. More research on nation-wide racial/ethnic disparities in obstetric anesthesia is needed to understand its broader practice and management in the USA.

Keywords: analgesia; anesthesia; opioids; pain; pain assessment; pain management.

Plain language summary

While racial/ethnic disparities in maternal mortality and morbidity are well documented, there is limited information on disparities in anesthesia practices for pregnant women. Consequently, this paper reviews literature on racial/ethnic disparities in maternal pain management during and after delivery. Current literature demonstrates racial/ethnic disparities in several aspects of obstetric pain management care including epidural use for vaginal labor pain, regional versus general anesthesia for cesarean delivery, epidural anesthesia complications, pain management after delivery and postural puncture headache treatment practices. However, many available studies are dated or limited to single institutions or states. Therefore, more research on nation-wide racial/ethnic disparities in obstetric pain management is needed to understand its broader practice and management in the USA.

Publication types

  • Review

MeSH terms

  • Anesthesia, Obstetrical*
  • Cesarean Section
  • Delivery, Obstetric* / adverse effects
  • Female
  • Humans
  • Pain Management
  • Pregnancy
  • Racial Groups