Study indicates pain treatment may vary in Latino and white children post surgery

Differences might exist in the amount of pain medicine given to Latino and white children after surgery, found a new, small study in which Latino children received 30 percent less opioid analgesics (morphine or morphine-like drugs) than white children did.

During surgery, administration of non-opioid analgesics (such as acetaminophen) and opioid analgesics was similar between Latino and white children, said lead study author Nathalia Jimenez, M.D., of Seattle Children's Hospital. However, the significant difference after surgery suggests that pain treatment in children has some correlation with the patient's ethnicity, according to the authors.

"The population in the United States is changing. Twenty-five percent of all the kids are Latino," Jimenez said. "This is a little window to see how different people are treated or react differently to pain."

The study, which appears in the February issue of the Journal of Health Care for the Poor and Underserved, compared the anesthetic and recovery period records of Latino and white children who had tonsillectomy and adenoidectomy surgery at Seattle Children's Hospital between 2003 and 2005. Ninety-four patients were included in the study, evenly divided between Latinos and whites.

The difference in treatment might have been due to communication difficulties between the health care providers and the patients and their families, according to the researchers, who also suggested that Latino children might need smaller amounts of opioid analgesics after surgery, perhaps due to biological factors.

"This hypothesis is a stretch," said Luisa Borrell, associate professor with the graduate program in public health at Lehman College, City University of New York. "The studies that the authors cite on the way Latinos process or assimilate analgesics were conducted on adults, not children."

The new study has a few limitations, Jimenez and Borrell agreed. Because it looked at medical records, "you only have the information that was documented when surgery was done and inevitably you have some missing data," Jimenez said.

Some of that missing data include information regarding how much pain the children experienced following surgery. Jimenez said that, based on the records, both sets of children were comfortable, but the records (of both the Latino and white patients) were not always complete.

Borrell said she would like to see the researchers collect data on the parents' health insurance. "We do know that people get treated differently when they go to the hospital according to the insurance they have," she said.