Examining Sociodemographic Disparities in the Use of Peripheral Nerve Blocks After Pilon Fractures

Recent studies have shown racial and ethnic disparities in patients receiving peripheral nerve blocks for perioperative pain management. PNBs are associated with decreased opioid use, improved post-operative pain control and decreased length of stay (Pack, 2020). There are further opportunities for examining sociodemographic variables such as language, gender, or insurance type. We extracted data regarding receipt of PNBs and sociodemographic variables from our electronic medical record for patients hospitalized after sustaining a pilon fracture between March 2021 and October 2023 (N = 225). Using chi-square analyses, we examined differences in the receipt of a PNB by various sociodemographic variables; including race, ethnicity, gender, language spoken, and type of insurance. The average age was 42.56 (SD = 15.64), majority identified as male (71%), white (78%), non-Hispanic or Latino (84%), and English speaking (94.2%), had public insurance (50.7%), and 44.9% of our sample received a PNB. There were no significant differences across selected sociodemographic variables. This contrasts with recent literature suggesting disparities in use of regional anesthesia by race and ethnicity. Limitations of our study include a small sample size and a predominantly homogeneous sample with regards to race and ethnicity and language spoken. Disparities in pain management are an important and understudied focus in regional anesthesia and post-operative pain management. Future examination of disparities within a larger, more nationally representative sample is warranted.