Butler R, Fuller J
Department of Anaesthesia, London Health Sciences Centre, Ontario.
Can J Anaesth. 1998 Aug;45(8):724-8. doi: 10.1007/BF03012141.
To determine the factors associated with the development of post-partum back pain following epidural anaesthesia for labour and delivery and its incidence.
A prospective observational cohort study was conducted in a University affiliated tertiary care hospital. Women presenting for labour and delivery who were planning to have epidural anaesthesia were eligible for study. Baseline data were obtained from the women and obstetrical and anaesthetic data from the hospital chart. Women were contacted by phone at four to six weeks post-partum and questioned regarding the presence of any back pain and pain lasting longer than 14 days.
Three hundred women entered the study and follow-up was obtained in 270 (90%). The incidence of back pain was 30.7% and back pain lasting longer than 14 days was 8.5%. Nulliparity was associated with a decreased risk of developing back pain post-partum but this decrease was only associated with pain lasting more than 14 days: Odds Ratio (OR) [95% confidence interval] 0.32 [0.11-0.94]. A previous history of back pain was strongly associated with the development of any back pain (OR 43.85 [9.97-192.9] but not with pain lasting longer than 14 days (OR 2.16 [0.71-6.58]). Age, weight and the duration of the second stage of labour were not associated with the development of back pain.
Back pain following epidural anaesthesia is common but persistent back pain is much less common. A previous history of back pain increases the likelihood of post-partum back pain following epidural anaesthesia. Nulliparity is associated with a decreased risk.
确定与分娩及分娩时硬膜外麻醉后产后背痛发生相关的因素及其发生率。
在一所大学附属三级护理医院进行了一项前瞻性观察队列研究。计划进行硬膜外麻醉的分娩妇女符合研究条件。从这些妇女处获取基线数据，并从医院病历中获取产科和麻醉数据。在产后四至六周通过电话联系这些妇女，询问她们是否存在任何背痛以及疼痛持续时间是否超过14天。
300名妇女进入研究，270名（90%）获得了随访。背痛的发生率为30.7%，疼痛持续超过14天的发生率为8.5%。初产与产后发生背痛的风险降低相关，但这种降低仅与持续超过14天的疼痛有关：优势比（OR）[95%置信区间]为0.32[0.11 - 0.94]。既往背痛史与任何背痛的发生密切相关（OR 43.85[9.97 - 192.9]），但与持续超过14天的疼痛无关（OR 2.16[0.71 - 6.58]）。年龄、体重和第二产程持续时间与背痛的发生无关。
硬膜外麻醉后背痛很常见，但持续性背痛则少见得多。既往背痛史会增加硬膜外麻醉后产后背痛的可能性。初产与风险降低相关。
