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Incidence of newly developed postoperative low back pain with median versus paramedian approach for spinal anesthesia

대한마취과학회지 2020년 73권 6호 p.518 ~ 524
이정하, 윤대훈, 허봉하,
소속 상세정보
이정하 ( Lee Jung-Ha ) - Gwangju Christian Hospital Department of Anesthesiology and Pain Medicine
윤대훈 ( Yoon Dae-Hun ) - Gwangju Christian Hospital Department of Anesthesiology and Pain Medicine
허봉하 ( Heo Bong-Ha ) - Gwangju Christian Hospital Department of Anesthesiology and Pain Medicine

Abstract


Background: The effects of anesthetic techniques on postdural puncture backache (PDPB) have not been specifically evaluated. The purpose of this study was to compare the incidence and severity of PDPB between median and paramedian techniques.

Methods: Patients were randomized to receive spinal anesthesia by either a median (Group M, n = 50) or paramedian (Group P, n = 50) approach.We recorded each patient’s personal number of puncture attempts, surgical position, and operation duration. We investigated the incidence and intensity of back pain 1 day, 1 week, and 1, 2, and 3 months postoperatively.

Results: The overall incidence of PDPB was higher in the Group M (18/50, 36%) than in the Group P (8/50, 16%) (P = 0.023). Twenty-four hours after surgery, 8 patients in Group M and 6 patients in Group P complained of back pain. Seven days after the surgery, 16 patients in the Group M and 5 patients in the Group P complained of pain (P = 0.007). After 1 month, 5 patients in the Group M and 1 patient in the Group P complained of pain. Only one patient in each group complained of pain after 3 months. No significant differences were noted in NRSs between the groups during study period.

Conclusions: The results of this study suggest that spinal anesthesia using the paramedian approach reduces the incidence of PDPB during the early postoperative period.

키워드

Adverse effects; Anesthesia; Low back ache; Median-paramedian; Numeric rating scale; Spinal

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