Incidence of back pain following spinal anesthesia and its relationship to various factors in 176 patients

Abstract

Objective: After neuraxial anesthesia, back pain is the most common complaint. The back pain may be related to needle trauma or surgical positioning or transient neurotoxicity of concentrated local anesthetics. The goal of this study was to compare the incidence of back pain following spinal anesthesia with hyperbaric lidocaine 5% and bupivacaine 0.5% and spinal needle insertion spaces. Methodology: In this clinical trial after approving ethics committee and obtaining patients consent, we included 176 adult patients with physical status of I- II ASA from May 2006 to May 2008 undergoing various elective urologic surgeries under spinal anesthesia in Imam Hospital in Tabriz, Iran. Patients were allocated randomly in two equal groups. Group lidocaine, a nesthetized with hyperbaric 5% lidocaine and group bupivacaine. All patients were interviewed 6, 24, 48 hours after surgery for back pain. Results: This study indicated no statistically significance difference in the incidence of back pain following spinal anesthesia considering age and frequency of needle puncture during spinal anesthesia. Incidence of back pain was higher in lidocaine group than bupivacaine group (31.82% vs. 18.18%; respectively; P<0.001).Incidence of back pain was higher in L3-4 interspace of needle insertion than L4-5 (23.7% vs. 12.8%, respectively; P<0.001). The intensity of back pain was slight and tolerable in 77% of the cases, and the back pain in all the patients lasted not more than 48 hours. Conclusion: This study implies that the area of needle insertion and type of anesthetics have effects on the back pain following spinal anesthesia.