The Influence of Cultural Group on the Undertreatment of Postoperative Pain1

Abstract

Culture is widely recognized to be an important determinant of pain response, yet little is known about the interactions of culture with other variables or about the relationship between culture and the treatment of pain in the clinical setting. This study analyzes the variance in postcholecystectomy narcotic requirements accounted for by racial group in a multiethnic setting. Caucasians and Hawaiians received significantly more analgesics than Filipinos, Japanese, or Chinese. Race and its interactions with age and sex accounted for 11% of the variance. All groups were notably undertreated for pain. While individual factors are probably of greatest importance in the treatment of postoperative pain, cultural factors do contribute to the variability. Whether this reflects ethnic differences in analgesic requirements or reflects cultural bias in treatment remains to be determined. In a milieu of undertreatment of pain, some cultural styles may be more susceptible to undertreatment than others.