Acute Back Pain Following Surgery under Spinal Anesthesia

The purpose of this study was to determine the factors having a role in the occurrence of acute back pain following spinal anesthesia.

Six hundred and forty-nine patients who underwent surgery under spinal anesthesia were enrolled in this prospective observational study. Patients' age, sex, BMI, ASA physical status, educational status, history of back pain, spinal needle radius, spinal interspace level of intervention, method of approach for spinal anesthesia, position during spinal anesthesia, angle of puncture with respect to the spinal ligaments, magnitude of pain during intervention, number of lumbar punctures, number of bony contacts, amount of bupivacaine administered intrathecally, type of surgical procedure, surgical position, duration of the surgery, and duration of anesthesia parameters were recorded. Patients were inquired for existence and magnitude of back pain on the 1st day and the 4th week postoperatively. Multivariate analysis is performed via logistic regression model to parameters that are found to be significant in univariate analysis.

Assessment of the data from the postoperative 1st day showed 29.3% of the patients suffered back pain. Postspinal acute back pain was related to the number of bony contacts (P = 0.016), history of back pain (P = 0.0001), spinal needle radius (P = 0.022), and duration of the surgery (P = 0.037).

Contrary to the common belief, it is demonstrated in this study that number of lumbar punctures, method of approach and position of the spinal anesthesia, age, sex, surgical position, and the type of the surgery did not correlate with occurrence of acute back pain following spinal anesthesia.