Exploring inequities in regional anesthesia: a review of perioperative access and outcomes

Regional anesthesia (RA) is an effective perioperative pain management modality that primarily uses nerve blocks, including neuraxial anesthesia. A growing body of evidence suggests that RA provides several benefits, including better pain control, reduced opioid consumption, and quicker recovery time, as well as lower risk of adverse effects such as postoperative nausea and vomiting, ileus, respiratory failure, and cardiac complications that are more common with the use of general anesthesia (GA). The use of RA has grown steadily in recent years, yet there are persistent differences in utilization rates across sociodemographic groups. Access to RA includes the availability, offer, and uptake of neuraxial or peripheral nerve blocks in the perioperative setting, and is shaped by clinical, institutional, and systemic factors. Disparities may exist in whether such techniques are offered or used across racial, ethnic, socioeconomic, and educational lines, reflecting broader issues of healthcare equity, implicit bias, and structural barriers. This review synthesizes the current literature to better understand existing disparities in access to and utilization of RA. Gaining deeper insight into these disparities can help provide a more comprehensive understanding of RA utilization and access and inform strategies to reduce these inequities in the future.