Association of Patient Race and Hospital with Utilization of Regional Anesthesia for Treatment of Postoperative Pain in Total Knee Arthroplasty: A Retrospective Analysis Using Medicare Claims

ConclusionsRace was not associated with administration of regional anesthesia in Medicare patients undergoing primary total knee arthroplasty. Variation in the use of regional anesthesia was primarily associated with the hospital where surgery occurred.Editor ’s PerspectiveWhat We Already Know about This TopicRegional analgesia for management of postoperative pain after total knee arthroplasty is recommended by numerous relevant societiesBlack patients undergoing total knee arthroplasty have worse outcomes compared to White patientsPrevious analyses of postoperative analgesia management among commercially insured patients demonstrate lower frequency of peripheral nerve blocks among Black patients compared to White patientsWhat This Article Tells Us That Is NewAmong 733,406 primary total knee arthroplasty surgeries between January 1, 2011, and December 31, 2016, in the Medicare database, 90.7% of patients identified as White, 4.7% as Black, and 4.6% as OtherBlack patients did not have a statistically different probability of receiving a regional anesthetic compared to White patients (adjusted estimates: Black, 53.3% [95% CI, 52.5 to 54.1%]; White, 52.7% [95% CI, 52.4 to 54.1%];P = 0.132)After adjustment for other patient-level confounders, 42.0% of the variation in block administration was attributable to the hospital, compared to less than 0.01% to raceRace was not associated with administration of regional anesthesia in Medicare patients undergoing primary total knee arthr...
Source: Anesthesiology - Category: Anesthesiology Source Type: research