The Influence of Race, Ethnicity and Genetic Variants on Postoperative Pain Intensity: An Integrative Literature Review

Pain Manag Nurs. 2019 Jun;20(3):198-206. doi: 10.1016/j.pmn.2018.11.002. Epub 2019 May 10.

Abstract

Objectives: Chronic postsurgical pain is pain that develops and persists for at least 3 months after a surgical procedure. The purpose of this review was to discover what evidence exists regarding the influence of race and ethnicity on postoperative pain intensity and what evidence exists regarding the influence of genetic polymorphisms on postoperative pain intensity.

Design: Integrative literature review.

Data sources: CINAHL, PsychInfo, SCOPUS, and PubMed/Medline databases were searched for entries within the last 10 years. Sources included primary research investigating the relationship among race, ethnicity, and genetics in postoperative pain outcomes.

Review/analysis methods: Studies adhered to a strict inclusion and exclusion criteria. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were utilized to evaluate and assess manuscripts for inclusion.

Results: Twelve manuscripts were included for final review. There are significantly higher preoperative and postoperative pain intensity scores reported between African American and Hispanic individuals compared with non-Hispanic whites. Although some studies identified that non-Hispanic whites consumed more opioids and reported increased pain, there were no significant differences in opioid requirements in Hispanic and non-Hispanic individuals. COMT and OPRM1 were the most identified genetic polymorphisms associated with postoperative pain intensity.

Conclusions: The literature varies with respect to race, ethnicity, and postoperative pain perception. Perioperative pain intensity has been suggested as a significant predictor of chronic postsurgical pain. COMT and OPRM1 may be associated with higher pain perception after surgical procedures.

Publication types

  • Review

MeSH terms

  • Black People / ethnology
  • Black People / psychology
  • Black People / statistics & numerical data
  • Ethnicity / psychology
  • Ethnicity / statistics & numerical data*
  • Genetic Variation
  • Hispanic or Latino / psychology
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Pain Measurement / instrumentation
  • Pain Measurement / methods
  • Pain, Postoperative / classification*
  • Pain, Postoperative / ethnology
  • Racial Groups / ethnology
  • Racial Groups / psychology
  • Racial Groups / statistics & numerical data*
  • White People / ethnology
  • White People / psychology
  • White People / statistics & numerical data