Intrapartum analgesia and its association with post‐partum back pain and headache in nulliparous women

Orlikowski, Christopher E. P.; Dickinson, Jan E.; Paech, Michael J.; McDonald, Susan; Nathan, Elizabeth

doi:10.1111/j.1479-828x.2006.00624.x

Cited by 26 publications

(13 citation statements)

References 37 publications

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“…, Mogren & Pohjanen ), Australia (96% during pregnancy, Orlikowski et al . ), North America (69%, Wang et al . ) and East Asia (75–77%, To & Wong , Chang et al .…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with low back pain changes during the third trimester of pregnancy

Chang

Lai

Jensen

et al. 2013

Journal of Advanced Nursing

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“…, Mogren & Pohjanen ), Australia (96% during pregnancy, Orlikowski et al . ), North America (69%, Wang et al . ) and East Asia (75–77%, To & Wong , Chang et al .…”

Section: Introductionmentioning

confidence: 99%

“…, To & Wong , Orlikowski et al . ), higher physical workload (Mogren ), a higher body mass index (BMI) (Gutke et al . ) and lack of exercise (Mogren ).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with low back pain changes during the third trimester of pregnancy

Chang

Lai

Jensen

et al. 2013

Journal of Advanced Nursing

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“…1 The incidence of hypotension was 0% in the prehydrated group and 100% in the control group. There was no benefit to colloid prehydration in decreasing the incidence of hypotension when a low-dose spinal anesthetic was combined with an epidural injection.…”

Section: Commentmentioning

confidence: 89%

Group Intervention for Women with Pelvic Girdle Pain in Pregnancy: A Randomized Controlled Trial

2007

Obstetric Anesthesia Digest

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85(11):1320-6 Low back and pelvic pain is common during pregnancy and postpartum. This study assessed whether a group intervention program for pregnant women with pelvic girdle pain would have any effect on pain and daily function at 6 and 12 mo postpartum.Participants at 18 to 32 wk gestation with posterior pelvic pain or pain from the symphysis pubis were referred from the surrounding community. During a 3-yr period, 958 women were examined for inclusion, and 569 fulfilled the inclusion criteria: a positive posterior pelvic pain provocation (P4) test or positive symphysis pressure test; pelvic girdle pain caused by at least two of the following, e.g., walking 10 min, standing 10 min, climbing stairs 2 floors, or turning in bed; and a negative neurologic back examination. There were 275 in the intervention group and 285 controls. All patients completed a questionnaire about daily activities and function, work, previous health, and background variables. Pain was measured on a 10-point visual analog scale (VAS). Women in the intervention group participated in an education program in groups of five women, with one session for 2 h once a week for 4 consecutive weeks. The control patients were not offered any treatment but were free to seek advice or receive other treatment. The intervention included information on anatomy, ergonomics/body posture, exercises, and pain management; advice on movements of daily life; demonstration of a pelvic belt, crutches, and an easy-slide for turning in bed; and information about delivery and care of the pelvis in the puerperal period. The VAS, P4, and symphysis pressure test were repeated 6 and 12 mo postpartum. The mean gestational age at inclusion was about 24 wk, and mean onset of pelvic pain was at week 15; 33% of women were primigravida and 43% had low back pain earlier, not related to pregnancy. At the time of inclusion, 66% were on sick leave and 33% on partial sick leave. The groups did not differ with regard to the above variables or in demographic characteristics. At inclusion, 59% of the 958 women had a minimum of one positive provocation test, 41% had a negative test, and 9 dropped out; 26% had a combination of a positive symphysis pressure and P4 test, 20% had a positive symphysis pressure test only, and 54% a positive P4 test only. Pain intensity by VAS score decreased from a median of 6 at inclusion to 0 or 1 at 6 and 12 mo postpartum in both groups. The groups did not differ in VAS score, either during pregnancy or at any of the postpartum time points. At 6 mo postpartum, 57 intervention patients were lost to follow-up, as well as 76 controls; 55% in both groups had positive provocation tests. Further dropout at 12 mo was similar between groups. At 12 mo, 80% in the intervention group and 72%, in the control group had positive provocation tests; 90% of the intervention group self-evaluated the utility of participating in the treatment group (VAS 0-10), and 4% scored 0 to 4.9; 11% scored 5 to 6.9; and 75% between 7 and 10. Among the controls, 60% sought treatment...

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“…Despite being an invasive technique, the safety of neuraxial analgesia con tinues to improve, with serious or longterm com plications exceptionally rare [12]. Intrapartum uri nary retention, a small impact on vaginal delivery rates in nulliparous labor and unintentional dural puncture leading to postdural puncture headache remain relatively common (the latter 0.5-2%), but postpartum back pain or cesarean delivery rates are not increased [61,62].…”

Section: Neuraxial Analgesia In Labormentioning

confidence: 97%

Analgesia for Childbirth: Modern Insights Into an Age-Old Challenge and the Quest for an Ideal Approach

Tulp

Paech

2013

Pain Manage.

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It is widely recognized that childbirth may be the most painful experience in a woman's lifetime and that women have a right to relief. There are many options, but the efficacy of only a few is supported by robust evidence. Many influences determine which method of pain relief is chosen, including social and cultural factors, availability, cost and personal preference. Due to human diversity and the differing perspectives of consumers, obstetric care providers and health administrators, there is no such thing as 'an ideal approach'. In resource-rich societies, major advances in parturient safety and outcome flow from technique development and better monitoring. Greater awareness of the negative impact of untreated pain and of the relevance of genetic, cultural and social factors motivates research into better predictive models, novel therapies and optimization of existing methods.

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Intrapartum analgesia and its association with post‐partum back pain and headache in nulliparous women

Abstract: This analysis supports previous research suggesting that epidural analgesia is not a significant risk factor for persisting post-partum back pain, headache or migraine.

Cited by 26 publications

References 37 publications

Factors associated with low back pain changes during the third trimester of pregnancy

Factors associated with low back pain changes during the third trimester of pregnancy

Group Intervention for Women with Pelvic Girdle Pain in Pregnancy: A Randomized Controlled Trial

Analgesia for Childbirth: Modern Insights Into an Age-Old Challenge and the Quest for an Ideal Approach

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