Is neuraxial anesthesia related to chronic low back pain among parturients who undergo cesarean delivery?
Chronic low back pain (LBP) is one of the most common problem observed throughout the world especially during pregnancy and after delivery. The exact causes responsible for LBP are not clear till date. In this study, efficient results were drawn out to probe the risk of chronic LBP in parturients undergoing cesarean delivery (CD) with neuraxial anesthesia (NA). No proper conclusions have been inferred regarding the relationship between chronic low back pain and epidural labor analgesia. Thus, this population-based retrospective cohort study have been executed nationwide to inspect the relationship between CD with NA and subsequent LBP.
The Taiwan National Health Insurance Research Database (NHIRD) was used to spot all primiparas who had given birth between January 1, 2000 and December 31, 2013. Women who had CD and vaginal delivery (VD) were considered using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes. The mode of anesthesia was verified by the NHI codes. Also, the Multivariable logistic regression helped to determine the probability of postpartum LBP in women undergoing CD with NA compared with those having VD.
The follow-up was the detection of LBP as per the first ICD-9-CM diagnosis code. Observations of the patients was done for 3 years after delivery or until diagnosis of postpartum LBP, abolition from the NHI system, death, or December 31, 2013.
Out of the total 61,027 primiparas who experienced delivery during the observation period, 40,057 were eligible for inclusion in this research study. From these women, 27,097 (67.6%) acquired VD, 8662 (21.6%) received CD with spinal anesthesia, and 4298 (10.7%) received CD with epidural anesthesia (EA). The women who encountered CD with EA were found to have a greater risk of LBP than did women who received VD, with the calibrated OR being 1.26 (95% CI: 1.17–1.34).
It was found that CD with EA might intensify the risk of subsequent chronic LBP.