Abstract
OBJECTIVE--To examine the relation between epidural anaesthesia and long term backache after childbirth. DESIGN--Data from postal questionnaire on morbidity after childbirth sent to women who had delivered in one maternity hospital between 1978 and 1985 were linked to maternity case notes for each woman. SETTING--Maternity hospital in Birmingham. SUBJECTS--11,701 Women who had delivered their most recent baby at the maternity hospital during the defined period and who returned their completed questionnaires. MAIN OUTCOME MEASURES AND RESULTS--Of the 1634 women who reported backache, 1132 (69%) had had it for over a year. A significant association was found between backache and epidural anaesthesia (relative risk = 1.8); 903 of 4766 women (18.9%) who had had epidural anaesthesia reported this symptom, compared with 731 of the 6935 women (10.5%) who had not had epidural anaesthesia. This association was consistent in both "normal" and "abnormal" deliveries, the only exception being after an elective caesarean section when no excess backache occurred after epidural anaesthesia. CONCLUSIONS--The relation between backache and epidural anaesthesia is probably causal. It seems to result from a combination of effective analgesia and stressed posture during labour. Further investigations on the mechanisms causing backache after epidural anaesthesia are required.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Crawford J. S. A prospective study of 200 consecutive twin deliveries. Anaesthesia. 1987 Jan;42(1):33–43. doi: 10.1111/j.1365-2044.1987.tb02942.x. [DOI] [PubMed] [Google Scholar]
- Crawford J. S. Lumbar epidural block in labour: a clinical analysis. Br J Anaesth. 1972 Jan;44(1):66–74. doi: 10.1093/bja/44.1.66. [DOI] [PubMed] [Google Scholar]
- Crawford J. S. Some maternal complications of epidural analgesia for labour. Anaesthesia. 1985 Dec;40(12):1219–1225. doi: 10.1111/j.1365-2044.1985.tb10664.x. [DOI] [PubMed] [Google Scholar]
- David H., Rosen M. Perinatal mortality after epidural analgesia. Anaesthesia. 1976 Oct;31(8):1054–1059. doi: 10.1111/j.1365-2044.1976.tb11944.x. [DOI] [PubMed] [Google Scholar]
- Dawkins C. J. An analysis of the complications of extradural and caudal block. Anaesthesia. 1969 Oct;24(4):554–563. doi: 10.1111/j.1365-2044.1969.tb02909.x. [DOI] [PubMed] [Google Scholar]
- Grove L. H. Backache, headache and bladder dysfunction after delivery. Br J Anaesth. 1973 Nov;45(11):1147–1149. doi: 10.1093/bja/45.11.1147. [DOI] [PubMed] [Google Scholar]
- Maltau J. M., Egge K. Epidural analgesia and perinatal retinal haemorrhages. Acta Anaesthesiol Scand. 1980 Apr;24(2):99–101. doi: 10.1111/j.1399-6576.1980.tb01515.x. [DOI] [PubMed] [Google Scholar]
- Morgan B. M., Aulakh J. M., Barker J. P., Reginald P. W., Goroszeniuk T., Trojanowski A. Anaesthetic morbidity following caesarean section under epidural or general anaesthesia. Lancet. 1984 Feb 11;1(8372):328–330. doi: 10.1016/s0140-6736(84)90371-4. [DOI] [PubMed] [Google Scholar]
- Morgan B. M., Bulpitt C. J., Clifton P., Lewis P. J. The consumers' attitude to obstetric care. Br J Obstet Gynaecol. 1984 Jul;91(7):624–628. doi: 10.1111/j.1471-0528.1984.tb04820.x. [DOI] [PubMed] [Google Scholar]
- Newsome L. R., Bramwell R. S., Curling P. E. Severe preeclampsia: hemodynamic effects of lumbar epidural anesthesia. Anesth Analg. 1986 Jan;65(1):31–36. [PubMed] [Google Scholar]
- Robinson J. O., Rosen M., Evans J. M., Revill S. I., David H., Rees G. A. Maternal opinion about analgesia for labour. A controlled trial between epidural block and intramuscular pethidine combined with inhalation. Anaesthesia. 1980 Dec;35(12):1173–1181. doi: 10.1111/j.1365-2044.1980.tb05074.x. [DOI] [PubMed] [Google Scholar]