Demographic disparities in the prescription of patient-controlled analgesia for postoperative pain

Whilst the influence of age, gender, insurance status and ethnicity on pain management has been previously reported, to our knowledge, no studies have assessed the influence of these characteristics on physicians' decisions to prescribe intravenous patient-controlled analgesia (IV PCA) as opposed to intramuscular injection (IMI) of opioid analgesia. This retrospective audit of 115 patients undergoing abdominal surgery was conducted to determine the influence of age, gender, insurance status and patient ethnicity (Caucasian versus ethnic minority) on the prescription of PCA or IMI analgesia for postoperative pain. Logistic regression was performed to determine independent associations and the odds ratios for being prescribed PCA or IMI opioid analgesia. The results indicate that the only significant independent predictor for PCA prescription was patients' ethnicity, with minority patients less likely to be prescribed PCA for postoperative pain management (P = 0.034). This study therefore suggests that PCA prescription is influenced by patients' ethnicity.