Evaluation of Acute and Chronic Back Pain After Spinal Anesthesia in Midline and Paramedian Approach: Incidence and Functional Disability

Abstract

Background: The intensity of low back pain and functional disability in life is a common question of patients before spinal anesthesia. We aimed to compare acute and chronic back pain after spinal anesthesia in midline and paramedian approach.
Methods: Two hundred twenty patients elective patients (25-65 year old) candidates for general, and urological surgery under spinal anesthesia, were allocated into the following two groups: Group M (midline) and Group P (paramedian). Spinal anesthesia was performed with hyperbaric bupivacaine 0.5% in the sitting position using a 25G Quincke needle in L3/L4 orL4/L5 level. During the operation, patients were placed in the supine position. The questionnaire assessed back pain and severity of pain with VAS score three days after spinal anesthesia. If the patients complained of back pain then, the effect of back pain on quality of life and the degree of patient's functional disability were assessed by Oswestry Disability Index on,45 and 90 days after surgery.
Results: Forty-one patients (18%) had back pain after the operation, 22 patients were in the paramedian (54%) and 19 patients (46%) in the midline method of spinal anesthesia. (p=0.6). The mean intensity of back pain was 2.27vs1.45 (p=0.5) and the total number of mean functional disability index was less than five in both groups.
Conclusion: The incidence of back pain was 18% and was not significantly different between the midline and paramedian methods. The severity of back pain decreased after three days, reaching to less than one on day the 45th and 90th, which does not affect daily patient’s functions.