Abstract
IntroductionPain is a common emergency department (ED) complaint. It is important to understand the differences in pain perception among different ethnic and demographic populations.MethodsWe applied a standardized painful stimulus to Caucasian and Latino adult patients to determine whether the level of pain reported differed depending on ethnicity (N=100; 50 Caucasian [C], 50 Latino [L] patients) and gender (N=100; 59 female, 41 male). Patients had an initial pain score of 0 or 1. A blood pressure cuff was inflated 20 mm HG above the patient’s systolic blood pressure and held for three minutes. Pain scores, using both a 10-cm visual analog scale (VAS) and a five-point Likert scale, were taken at the point of maximal stimulus (2 minutes 50 seconds after inflation), and at one- and two-minute intervals post deflation.ResultsThere was a statistically significant difference between the Likert scale scores of Caucasian and Latino patients at 2min 50sec (mean rank: 4.35 [C] vs. 5.75 [L], p<0.01), but not on the VAS (mean value: 2.94 [C] vs. 3.46 [L], p=0.255). Women had a higher perception of pain than males at 2min 50sec on the VAS (mean value: 3.86 [F] vs. 2.24 [M], p<0.0001), and the Likert scale (mean rank: 5.63 [F] vs. 4.21 [M], p<0.01).ConclusionLatinos and women report greater pain with a standardized pain stimulus as compared to Caucasians and men.
Highlights
Pain is a common emergency department (ED) complaint
Women had a higher perception of pain than males at 2min 50sec on the visual analogue scale (VAS), and the Likert scale
Todd et al found that reporting less than a 13 mm change in pain severity on the 100 mm visual analogue scale (VAS) was not clinically significant.[1]
Summary
Inequalities in analgesic administration to ED patients of different ethnic and demographic groups have been well documented, but there is limited data on objective differences in pain perception between these ethnic groups or between the two genders. Such differences would be clinically relevant as they could rationally affect the decision to use analgesics and the doses administered. This is especially important today when non-Caucasian minority groups comprise roughly one-third of the U.S population, a Volume 18, no. This is especially important today when non-Caucasian minority groups comprise roughly one-third of the U.S population, a Volume 18, no. 4: June 2017
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