title: Gender, age and ethnic aspects of analgesia in acute abdominal pain: is analgesia even across the groups?
abstract: BACKGROUND
  Numerous studies have shown differences in pain perception between men and women, which may affect pain management strategies.
  
  
  OBJECTIVE
  Our primary aim was to investigate whether there are gender-based differences in pain management in patients admitted to our emergency department with acute, non-specific abdominal pain (NSAP). Our secondary aim was to evaluate if other factors influence administration of analgesia for patients admitted with NSAP.
  
  
  METHODS
  From June 2007 to June 2008, we carried out a retrospective, gender-based, frequency-matched control study with 150 patients (75 consecutive men and 75 women) who presented with NSAP at our emergency department. Pain was documented using a numerical rating scale ('0' no pain, '10' most severe pain). A multinomial regression model was used to assess factors that might influence pain management.
  
  
  RESULTS
  No statistically significant difference was seen between men and women with respect to pain management (P= 0.085). Younger patients were, however, more likely to receive weaker (P= 0.011) and fewer analgesics (P < 0.001). Patients with previous abdominal surgery (P= 0.012), known chronic pain conditions (P= 0.029) or relevant comorbidities (P= 0.048) received stronger analgesia. Nationality (P= 0.244), employment status (P= 0.988), time of admission (P= 0.487) and known psychiatric illness (P= 0.579) did not influence pain management.
  
  
  CONCLUSIONS
  No statistically significant gender-dependent differences in pain management were observed. However, younger patients received less potent analgesic treatment. There is no reason for certain groups to receive suboptimal treatment, and greater efforts should be made to offer consistent treatment to all patients.
authors.affiliation: Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland. vanessa.banz@gmx.ch
authors.forename: V M
authors.initials: VM
authors.lastname: Banz
authors.forename: B
authors.initials: B
authors.lastname: Christen
authors.forename: K
authors.initials: K
authors.lastname: Paul
authors.forename: L
authors.initials: L
authors.lastname: Martinolli
authors.forename: D
authors.initials: D
authors.lastname: Candinas
authors.forename: H
authors.initials: H
authors.lastname: Zimmermann
authors.forename: A K
authors.initials: AK
authors.lastname: Exadaktylos
mesh_terms: D015746:Abdominal Pain / Q000188:drug therapy* / Q000208:ethnology / Q000523:psychology; D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D016022:Case-Control Studies; D015897:Comorbidity; D004522:Educational Status; D004651:Employment; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008571:Men / Q000523:psychology*; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage / Q000627:therapeutic use; D059408:Pain Management; D010147:Pain Measurement; D058748:Pain Perception / Q000502:physiology*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology; D014930:Women / Q000523:psychology*; D055815:Young Adult
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009294:Narcotics; D000082:Acetaminophen