Racial and Ethnic Differences in the Use of Regional Anesthesia for Patients Undergoing Total Knee Arthroplasty

Abstract

Background: There is an increasing body of evidence that suggests racial and ethnic disparities exist in medical care. In the field of anesthesiology, few studies have investigated the association of race and ethnicity with the provision of regional anesthesia for patients undergoing total knee arthroplasty. This analysis queried a large national surgical database to determine whether there were racial or ethnic differences in the administration of peripheral nerve blocks for patients undergoing total knee arthroplasty.

Methods: In this retrospective cohort study, data were collected from a large national database during the years 2017-2019. Multivariable logistic regressions were used to measure the association of race and ethnicity with utilization of regional anesthesia. The participants for the study were patients 18 years or older undergoing total knee arthroplasty.

Results: Our primary finding was that among patients undergoing total knee arthroplasty, Black patients had lower odds (adjusted odds ratio [aOR]: 0.93, 99% confidence interval [CI]: 0.89-0.98) of receiving regional anesthesia than White patients. Also, Hispanic patients had lower odds (aOR: 0.88, 99% CI: 0.83-0.94) of receiving regional anesthesia than non-Hispanic patients. Native Hawaiian/Pacific Islander patients had increased odds (aOR: 2.04, 99% CI: 1.66-2.51) of receiving regional anesthesia.

Conclusion: This study demonstrated that there might be racial and ethnic differences in the provision of regional anesthesia for patients undergoing total knee arthroplasty. These differences underscore the need for more studies aimed at equitable access to high quality and culturally competent health care.

Keywords: NSQIP; knee arthroplasty; nerve block; racial disparities; regional anesthesia.