THE EFFECT OF ETHNICITY ON PRESCRIPTIONS FOR PATIENT CONTROLLED ANALGESIA FOR POST-OPERATIVE PAIN
BERNARDO NG, JOEL E. DIMSDALE, JENS D. ROLLNIK, AND HARVEY SHAPIRO
The relationship between ethnicity and pain has been of interest to clinicians and researchers for many years. Since 1960, more than 200 articles have explored this association. Fewer articles have examined ethnicity and postoperative pain ( Pferrerbaum et al. 1990; van Aken et al. 1989; Streltzer and Wade 1981; Flannery 1981). Some of the studies found no ethnic differences ( Pfefferbaum et al. 1989; van Aken et al. 1989), others did find differences but could not relate them exclusively to ethnicity ( Streltzer and Wade 1981; Flannery, 1981). In the area of laboratory-induced pain, ethnic differences have not been demonstrated ( Zatzick and Dimsdale 1990).
Recently, a number of well-designed studies have appeared. Despite examining rather different populations, the studies reached similar conclusions-that ethnicity has a large impact on treatment of pain. One study from Los Angeles reported that Hispanic patients were less likely to receive analgesics in an emergency room than were non-Hispanic whites ( Todd et al. 1993). Another study from San Diego found ethnic differences in the amount of analgesic received for post-operative pain ( Ng et al. 1994). A recent multicenter study found that minority (black and Hispanic) patients were more likely to have inadequate analgesia for treatment of pain associated with metastatic cancer ( Cleeland et al. 1994).
One of the intriguing aspects of pain is that pain treatment requires an interaction between patients and staff, and transcultural studies have shown
This chapter is reprinted by permission of the International Asssociation for the Study of Pain and originally appeared in Pain 66 ( 1996), 9-12.