Perspectives on Analgesia in Patients with Nerve Blocks: A Pilot Survey of Perioperative Nurses.

Background: The influence of nerve blocks on treatment bias, a form of implicit bias where patient characteristics lead to inequal treatment, remains unexplored. Methods: This was a pilot study that utilized a survey to collect data from nurses at a single academic medical center. The following information was collected from the respondents: age (years); gender (male, female, other); nursing experience (years); specialization (surgery, medicine, emergency, perioperative, other); prior formal training on pain management in patients with or without nerve blocks; and how frequently they encounter patients with nerve blocks. Hypothetical clinical scenarios were presented to investigate pain medication dosing strategies that were rated with a 3-point Likert scale (more, equal, or less medication). Impacts of various patient conditions (alcohol abuse, anxiety, depression, marijuana use, nerve block, opioid abuse, and substance abuse) on pain medication and opioid dosing strategies were further investigated with a 5-point Likert scale (ranging from strongly disagree to strongly agree). Results: Overall, the survey had a 32.59% response rate. Treatment bias towards patients with nerve blocks was evident in 21.43% (9/42) and 11/30 (36.67%) of respondents for pain medications and opioids, respectively. Conclusion: This pilot study suggests that patients with nerve blocks may be treated differently than those without blocks, regardless of their reported pain. However, given the study's exploratory design, these findings should be interpreted as hypothesis-generating.