Persistent back pain after spinal anaesthesia in the non-obstetric setting: incidence and predisposing factors

Schwabe, Karen; Hopf, Hans‐Bernd

doi:10.1093/bja/86.4.535

Cited by 31 publications

(45 citation statements)

References 23 publications

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“…5 More recent studies on back pain after spinal anesthesia have reported the incidence to be 10% to 29% (Table 4). [43][44][45] One study noted the backaches to be mild in intensity, characterized by local tenderness at the site of injection, and responded to oral anti-inflammatory drugs or resolved spontaneously. 44 The exact duration of the back pain was not noted.…”

Section: Incidence Of Back Pain After Neuraxial Anesthesia: Preexistimentioning

confidence: 99%

“…The 5% incidence of back pain at 4 weeks, observed by Tekgül et al, 45 is closer to the 10% to 11% incidence noted earlier by other investigators. 43,44 From the studies mentioned, [43][44][45] it can be stated that the incidence of back pain after spinal anesthesia ranges from 9% to 29%. The pain is mild in intensity and decreases with time (level 1).…”

Section: Incidence Of Back Pain After Neuraxial Anesthesia: Preexistimentioning

confidence: 99%

“…The article by Kock and Hopf 47 was in German, but there were enough information in the abstract, which was in English, to be included in our review. In their other article on back pain after spinal anesthesia, 43 which was written in English, they stated that they used the same questionnaire in their criteria for back pain ("back pain, no TNS") in this study.…”

Section: Incidence Of Back Pain After Neuraxial Anesthesia: Preexistimentioning

confidence: 99%

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Back Pain and Neuraxial Anesthesia

Benzon

Asher

Hartrick

2016

Anesthesia &Amp; Analgesia

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The incidence of back pain after neuraxial anesthesia in the adult population is not different from that after general anesthesia. The pain is usually mild, localized in the low back, rarely radiates to the lower extremities, and has a duration of only a few days. The risk factors for development of back pain include the lithotomy position, multiple attempts at block placement, duration of surgery longer than 2.5 hours, body mass index ≥32 kg/m, and a history of back pain. However, there is no permanent worsening of preexisting back pain after neuraxial anesthesia. The back pain has been attributed to tears in the ligaments, fascia, or bone with localized bleeding; immobility of the spine; relaxation of the paraspinal muscles under anesthesia; flattening of the normal lumbar convexity; and stretching and straining of the lumbosacral ligaments and joint capsules. The addition of an anti-inflammatory drug to the local anesthetic used for skin infiltration may decrease the incidence and severity of back pain. The use of spinal or epidural anesthesia in the adult, non-obstetric and obstetric populations should depend on the advantages offered by the technique and not on the occurrence of back pain after the procedure. Additional studies are needed to confirm the efficacy of epidural dexamethasone, or other steroids, or the addition of an anti-inflammatory drug to the local anesthetic infiltration for the prevention of back pain after neuraxial anesthesia. Future studies should involve a physician with expertise in the evaluation of chronic low back pain to help identify the cause of the back pain and institute appropriate treatment(s).

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Section: Incidence Of Back Pain After Neuraxial Anesthesia: Preexistimentioning

confidence: 99%

Section: Incidence Of Back Pain After Neuraxial Anesthesia: Preexistimentioning

confidence: 99%

Section: Incidence Of Back Pain After Neuraxial Anesthesia: Preexistimentioning

confidence: 99%

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Back Pain and Neuraxial Anesthesia

Benzon

Asher

Hartrick

2016

Anesthesia &Amp; Analgesia

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“…In a study investigating waist pain after spinal anesthesia, patients were evaluated 5 days, 3 months, and 1 year after spinal anesthesia, and the incidence of pain was found as 18%, 10.7%, and 12.3%, respectively. However, when the patients' stories were carefully examined, it was determined that the majority of the patients had waist pain prior to spinal anesthesia, and after this correction, the procedure-related waist pain that occurred 3 months after spinal anesthesia was specified as only 0.8% (17). In our study, we contacted the patients via telephone 3 months after the procedure and questioned about the waist pain at the puncture site; we found this ratio as 6.3%, and no statistically significant difference was detected between the groups (Table 3).…”

Section: Discussionmentioning

confidence: 99%

Which Approach is Preferred in Spinal Anesthesia: Median or Paramedian? Comparison of Early and Late Complications

Bayindir¹,

Özcan²,

Koçyiğit³

et al. 2017

Istanbul Med J

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Spinal anesthesia is often preferred in short-term surgeries because it is a low-cost technique that can be applied easily, has a high success rate, and allows fast mobilization and early feeding (1). The side effects in this application can vary with the technique that is used (2). Inadequate spinal anesthesia, high or total spinal block, cardiac arrest, respiratory arrest, systemic toxic reaction, hypotension, bradycardia, nausea/vomiting, headache, spinal puncture pain, meningitis or meningismus, neurological sequelae, urinary retention, and hearing loss may be seen as a result of the effect created by the spread of the local anesthetic agent in the subarachnoid space (3).In our study, we aimed to compare the early and late complication rates of two different techniques (median or paramedian approach) in spinal anesthesia, which is the most preferred anesthetic method in our clinic for short-term surgeries. Material and MethodsOur study was conducted after the ethics committee approval no. 42883194-01/10405, dated November 18th, 2014, was received from the Ethics Committee of Fırat University Hospital. Of 282 patients who underwent short-term surgeries under spinal anesthesia between January 1st, 2014, and March 1st, 2014, 80 patients aged 18-65 years and classified as ASA I/II/III according to the American Society of Anesthesiologists (ASA) classification, who could be reached at telephone numbers that we had on file, were included in the study. Since the study was retrospective, informed consents were not received from the patients. The files of the patients were obtained from the archive, and the patients in whom the median technique was used were included in Group M (n=40), and those in whom the paramedian technique was used were included in Group P (n=40). Demographic data (age, gender, height, weight), ASA, the number of spinal anesthesia applications, duration of surgery, preoperative and intraoperative heart rate (HR), and mean arterial pressure (MAP) were recorded from the anesthesia follow-up chart, and the discharge durations from the hospital and the number of patients who underwent urinary catheterization were recorded from the nurse observation forms. Information was received from the patients who were contacted by phone about postoperative headache, pain at the site of procedure, hearing complaints, and about the other complaints. Which Approach is Preferred in Spinal Anesthesia: Median or Paramedian? Comparison of Early and Late ComplicationsIntroduction: Spinal anesthesia is usually preferred for short-time surgery; the side effects of the process can show difference with techniques. We aimed to compare early and late complications of median and paramedian techniques in spinal anesthesia.Methods: Eighty patients with American Society of Anesthesiologists (ASA) I-III were allocated into the following two groups: Group M (median) and Group P (paramedian). Demographic data of the patients, ASA score, number of spinal anesthesia application, total surgery time, discharge time from the hospital, h...

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“…It might be due to needle trauma, aseptic tendonitis, periosteitis, excessive stretching of ligaments after relaxation of Para spinal muscles with development of a supraspinous hematoma. Other contributing factors include type, duration of surgery, duration of immobilization, and the position of the patient during spinal puncture [3].…”

Section: Introductionmentioning

confidence: 99%

Randomized Control Study for Evaluation of Effectiveness of Topical NSAIDS Patches to Prevent Backache Following Spinal Anesthesia in Caesarean Section

Adelshoukry¹,

Abddelkway²

2018

OJAnes

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Background: Women who had caesarean section (CS) with spinal anaesthesia had more chances to develop low back pain. Controlled studies evaluating the prevention of back pain after neuraxial anaesthesia involved mostly the use of an anti-inflammatory medication or steroid, given epidurally or as part of the intradermal injectate. The purpose of this study is to determine the effect of topical Nonsteroidal Anti-inflammatory drugs (NSAIDS) patch on decreasing the incidence of post-operative backache following spinal anaesthesia for caesarean section. Patients and methods: One hundred thirty parturients aged 19 -40 years, American society of Anaesthesiology class I & II scheduled for elective caesarean section with spinal anaesthesia were divided randomly into two equal Groups (65 patients each): ketoprofen group (TDK) received 30 mg ketoprofen transdermal patch at site of puncture for 24 hours and control group (TDC) received a placebo transdermal patch at site of puncture for 24 hours. In the Postoperative period 24 hours after the spinal procedure, the transdermal patch was removed in both groups then symptoms of back pain have been determined by visual numerical scale (VNS). Results: regard incidence of occurrence and severity of back pain (VNS > 3) the results showed that the back pain was less in the TDK group than in the TDC group at 24 hours post spinal interval (4.6% vs 15.4%) respectively. On the other hand there was no statistical significant difference at 48 hours and 2 weeks post spinal interval. Conclusion: Prophylactic application of topical NSAIDS patch may reduce the incidence and the severity of short term backache after spinal anaesthesia in CS with negligible complications.

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Persistent back pain after spinal anaesthesia in the non-obstetric setting: incidence and predisposing factors

Cited by 31 publications

References 23 publications

Back Pain and Neuraxial Anesthesia

Back Pain and Neuraxial Anesthesia

Which Approach is Preferred in Spinal Anesthesia: Median or Paramedian? Comparison of Early and Late Complications

Randomized Control Study for Evaluation of Effectiveness of Topical NSAIDS Patches to Prevent Backache Following Spinal Anesthesia in Caesarean Section

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