The Impact of Race on Discrepancies in Pain and Opioid Administration Following Hysterectomy

INTRODUCTION: More than 400,000 hysterectomies are performed annually. Gynecologic healthcare disparities in route of hysterectomy and surgical complications have been reported. There is, however, a paucity of information on postoperative pain scores and opioid administration. Therefore, the objective was to evaluate postoperative total morphine equivalents and pain scores for laparoscopic/robotic and vaginal hysterectomies among reported races. METHODS: This was an institutional review board (IRB)-approved retrospective study. Subjects underwent laparoscopic/robotic or vaginal hysterectomy from October 2018 to November 2020. Primary outcome was total postoperative morphine equivalents. Secondary outcomes included pain scores, operative time, estimated blood loss, time in recovery, and length of hospital stay. RESULTS: A total of 1,270 subjects were identified: 70.5% (n=895) underwent laparoscopic/robotic hysterectomy and 28.7% (n=364) underwent vaginal hysterectomy. Of all subjects, 78.2% (n=993) were Caucasian, 18% (n=228) African American, 1.1% (n=14) Asian, and 2.8% (n=35) other. African Americans undergoing hysterectomy were younger, 45.7 vs 50.4 ( P <.001) and reported slightly higher pain scores 4.67 (3.1–6.0) vs. 4.13 (2.8–5.3) ( P =<.001) compared to Caucasians. Mean total morphine equivalents was not different at 20.5 (11.6) vs. 20.3 (10.5) ( P =.795). There was no difference in procedure length, time in recovery, or estimated blood loss. Although there was a difference in length of stay of 1.35 vs 1.5, the difference was less than 0.15 day. CONCLUSION: Most areas of interest demonstrated no difference between groups. Although a difference was noted in pain scores, the value is less than one and may have little clinical relevance. Further studies are warranted to help clarify this difference.