Abstract
Background Back pain is often reported as a common complaint after surgery. Many studies showed that the prevalence of back pain after spinal anesthesia is high and its magnitude is considerable in developing countries. It is highly related to reduced quality of life, loss of work productivity, burden of health care costs, and satisfaction regarding health care service; therefore, measures should be taken to reduce or prevented postspinal back. The aim of this cross-sectional study was to assess the prevalence and factors associated with back pain among patients undergoing spinal anesthesia at the University of Gondar Comprehensive and Specialized Hospital, Northwest Ethiopia. Methodology. An institutional based cross-sectional study was conducted from March to May 2020. A total of 215 participants were enrolled in this study. A convenience sampling technique was used to get the study participants. Both univariable and multivariable logistic regression were used to identify factors associated with postspinal back pain. Variables with a p value less than <0.2 in the bivariable analysis were fitted into the multivariable analysis. In the multivariable analysis, a variable with a p value of <0.05 was considered statistically significant. Results The overall prevalence of postspinal back pain was 40.5% (95% CI: 34.0, 47.4). Being overweight (AOR = 3.8; 95% CI: 1.47, 9.96) and obese (AOR = 4.9; 95% CI: 1.19, 20.4), using big spinal needles (AOR = 5.9; 95% CI: 1.04, 33.4), two attempts of lumbar puncture (AOR = 5.5; 95% CI: 1.74, 17.59), more than three attempts of lumbar puncture (AOR = 4.9; 95% CI: 1.63, 15.2), and the number of bone contacts during spinal anesthesia procedure (AOR = 3.1; 95% CI: 1.14, 8.45) were positively associated with postspinal back pain. Conclusion and Recommendation. The overall incidence of back pain is high. Body mass index, size of spinal needle, number of attempts, and number of bone contacts are significantly associated with the incidence of back pain following spinal anesthesia. Thus, it is better to minimize the number of lumbar puncture attempts and bone contacts during spinal anesthesia to reduce postspinal back pain. In addition, using smaller size spinal needle is a good choice.
Highlights
IntroductionSpinal anesthesia (SA) is the most commonly preferred and widely used anesthesia technique in surgeries like lower extremity surgery, anorectal, urologic, obstetric, and gynecologic interventions and lower abdominal procedures. [1, 2] Even though spinal anesthesia is the preferred technique, it has a lot of complications like postspinal back pain (PSBP) compared to general anesthesia (GA). [2,3,4,5,6].Back pain is a worldwide health problem affecting 50% and 80% of people at some time in their lives and it is a major physical and economical burden for the individual and the society [7,8,9,10]. e lifetime incidence of nonspecific low back pain is more than 84%, the incidence of chronic low Advances in Medicine back pain is about 23%, and 11-12% of the population suffered disability with this pain [11].Regardless of the anesthetic technique, postoperative low back pain is often reported as a common complaint after SA but the association between anesthetic technique and back pain is still unclear [12]
One of the common complications of spinal anesthesia in clinical practice is postoperative back pain. e reduction of this pain is mandatory to increase the quality of life, expand anesthesia outcomes, and improve patient satisfaction [3, 6]
The overall prevalence of postspinal back pain was 40.5%. is result was consistent with the study done in Germany (40%) [21]
Summary
Spinal anesthesia (SA) is the most commonly preferred and widely used anesthesia technique in surgeries like lower extremity surgery, anorectal, urologic, obstetric, and gynecologic interventions and lower abdominal procedures. [1, 2] Even though spinal anesthesia is the preferred technique, it has a lot of complications like postspinal back pain (PSBP) compared to general anesthesia (GA). [2,3,4,5,6].Back pain is a worldwide health problem affecting 50% and 80% of people at some time in their lives and it is a major physical and economical burden for the individual and the society [7,8,9,10]. e lifetime incidence of nonspecific low back pain is more than 84%, the incidence of chronic low Advances in Medicine back pain is about 23%, and 11-12% of the population suffered disability with this pain [11].Regardless of the anesthetic technique, postoperative low back pain is often reported as a common complaint after SA but the association between anesthetic technique and back pain is still unclear [12]. A study conducted in Ethiopia reported that 38.0%, 29.9%, and 16.0% of patients suffered PSBP in the 1st, 2nd, and 3rd postoperative days after SA, respectively [4]. Another study done in Asella, Ethiopia, showed that patients suffered backache in the postoperative 1st, 2nd, and 3rd days and 4th week after spinal anesthesia in surgical procedures with 38.0, 29.9, 16.0, and 31.6% respectively [17]. E aim of this cross-sectional study was to assess the prevalence and factors associated with back pain among patients undergoing spinal anesthesia at the University of Gondar Comprehensive and Specialized Hospital, Northwest Ethiopia. A convenience sampling technique was used to get the study participants Both univariable and multivariable logistic regression were used to identify factors associated with postspinal back pain. Using smaller size spinal needle is a good choice
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