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Incidence of self-limiting back pain in children following caudal blockade: an exploratory study
Teresa Valois1, Annik Otis, Manon Ranger
1Department of Anesthesia, The Montreal Children's Hospital, Montreal, Quebec, Canada. teresa.valoisgomez@mcgill.ca
Insights
Pediatric patients rarely experience back pain after caudal blockade, with incidence rates of 4.7% on day 2 and 1.1% on day 15 post-procedure. This information is crucial for parents and physicians regarding postoperative analgesia.
Area of Science:
- Pediatric Anesthesia
- Pain Management
- Neuraxial Injections
Background:
- Limited evidence exists on pediatric back pain post-neuraxial injections for postoperative analgesia.
- Adult studies report back pain after epidural blockade, but pediatric data is lacking.
- This study addresses the knowledge gap regarding back pain incidence in children after caudal blockade.
Purpose of the Study:
- To investigate the incidence of early and late-onset back pain symptoms in children following caudal blockade.
- To provide evidence-based information to pediatric patients and parents about potential side effects of caudal blockade.
- To establish baseline data on pediatric back pain after neuraxial anesthesia.
Main Methods:
- Prospective observational study of 135 pediatric patients (<18 years) undergoing caudal blockade.
- Data collected via patient self-report and parental observation over 15 days post-operation.
- Phone interviews on postoperative day 2 (POD2) and day 15 (POD15) using a seven-item symptom questionnaire.
Main Results:
- The incidence of back pain symptoms was 4.7% on POD2.
- The incidence of back pain symptoms decreased to 1.1% on POD15.
- Results indicate a low incidence of transient back pain in pediatric patients.
Conclusions:
- Transient, self-limiting back pain can occur in pediatric patients after caudal blockade.
- Findings offer valuable clinical information for physicians counseling patients and parents.
- Further research into factors associated with pediatric back pain post-caudal blockade is warranted.
Background:
Currently, in pediatric anesthesia, there is no evidence-based information available to pediatric patients and their parents regarding the incidence of back pain after neuraxial injections performed for postoperative analgesia. Back pain postepidural blockade has been reported in numerous studies with adult patients; however, it has not been investigated in children. The main objective of this study is to examine the incidence of back pain symptoms after caudal blockade (early and late onset) in children.
Methods:
Patients under the age of 18 years, who received caudal blockade at the Montreal Children's Hospital between July 2006 and December 2008 were recruited in this prospective observational study. Back pain was measured prospectively by patient self-report and parental observation during the 15-day postoperative period. Patients, or their parents, were contacted by phone on postoperative day 2 (POD2) and postoperative day 15 (POD15) to answer a seven-item symptom questionnaire.
Results:
In a sample of 135 children, the incidence of back pain symptoms was 4.7% and 1.1% on POD2 and POD15, respectively.
Conclusions:
The results of this study provide support that transient self-limiting back pain after caudal blockade does occur in pediatric patients. Clinically, this is useful information for physicians to provide to their patients. An exploration of factors that may be associated with back pain following caudal blockade in children is an interesting area of future research.
