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Lo C, Ross PA, Le S, Kim E, Keefer M, Rosales A. Engaging Parents in Analgesia Selection and Racial/Ethnic Differences in Analgesia Given to Pediatric Patients Undergoing Urologic Surgery. CHILDREN-BASEL 2020; 7:children7120277. [PMID: 33297304 PMCID: PMC7762314 DOI: 10.3390/children7120277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/02/2020] [Accepted: 12/04/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Family-centered care aims to consider family preferences and values in care delivery. Our study examines parent decisions regarding anesthesia type (caudal regional block or local anesthesia) among a diverse sample of children undergoing urologic surgeries. Differences in anesthesia type were examined by known predictors of health disparities, including child race/ethnicity, parental English proficiency, and a proxy for household income. METHODS A retrospective review of 4739 patients (including 25.4% non-Latino/a White, 8.7% non- Latino/a Asians, 7.3% non-Latino/a Black, 23.1% Latino/a, and 35.4% others) undergoing urologic surgeries from 2016 to 2020 using univariate and logistic regression analyses. RESULTS 62.1% of Latino/a parents and 60.8% of non-Latino/a Black parents did not agree to a regional block. 65.1% of Spanish-speaking parents with limited English Proficiency did not agree to a regional block. Of parents from households below poverty lines, 61.7% did not agree to a caudal regional block. In regression analysis, Latino/a and non- Latino/a Black youth were less likely to receive caudal regional block than non- Latino/a White patients. CONCLUSIONS We found disparities in the use of pediatric pain management techniques. Understanding mechanisms underlying Latino/a and non- Latino/a Black parental preferences may help providers reduce these disparities.
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Affiliation(s)
- Carl Lo
- Department of Anesthesiology Critical Care Medicine, Division of Pain Medicine, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (P.A.R.); (S.L.); (E.K.); (A.R.)
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
- Correspondence:
| | - Patrick A. Ross
- Department of Anesthesiology Critical Care Medicine, Division of Pain Medicine, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (P.A.R.); (S.L.); (E.K.); (A.R.)
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
| | - Sang Le
- Department of Anesthesiology Critical Care Medicine, Division of Pain Medicine, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (P.A.R.); (S.L.); (E.K.); (A.R.)
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
| | - Eugene Kim
- Department of Anesthesiology Critical Care Medicine, Division of Pain Medicine, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (P.A.R.); (S.L.); (E.K.); (A.R.)
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
| | - Matthew Keefer
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA
| | - Alvina Rosales
- Department of Anesthesiology Critical Care Medicine, Division of Pain Medicine, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (P.A.R.); (S.L.); (E.K.); (A.R.)
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