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Back pain following epidural anaesthesia in labour
1Department of Anaesthesia, London Health Sciences Centre, Ontario. rbutler1@julian.uwo.ca
Purpose:
To determine the factors associated with the development of post-partum back pain following epidural anaesthesia for labour and delivery and its incidence.
Methods:
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.
Results:
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.
Conclusions:
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.