Post-Operative Pain After Orthopedic Surgery: A Comparative Study Between the United States and Ethiopia.

Introduction: Post-operative pain management varies across healthcare systems and cultural contexts. While opioids are central in the United States, many countries rely on non-opioid strategies due to limited access or cultural norms. Authors of this study compared pain management strategies and outcomes among orthopedic trauma patients at academic centers in the United States and Ethiopia. Methods: A retrospective cohort study was conducted of patients undergoing orthopedic trauma surgery at Tikur Anbessa Specialized Hospital (Ethiopia) and the University of Kansas Health System (United States) between May and October 2022. Visual Analog Scale (VAS) pain scores at 24 and 48 hours post-operatively, analgesic use, and demographics were analyzed. Results: Ethiopian patients often were more male, younger, and had lower body mass indexes and fewer comorbidities (e.g., obesity, diabetes, smoking) than United States patients. Despite receiving fewer analgesics and no post-operative nerve blocks, Ethiopian patients reported lower VAS pain scores at both 24 and 48 hours. In the United States cohort, patients with nerve blocks had lower pain scores than those without; however, both groups reported higher scores than Ethiopian patients. In the United States, pain scores correlated positively with the number of analgesics administered. Conclusions: Ethiopian patients reported better pain control despite fewer interventions, suggesting that systemic, demographic, and cultural factors may strongly influence postoperative pain experiences. These findings underscore the importance of context-sensitive approaches to pain management and highlight the need for further research to inform equitable, effective strategies across diverse settings.