Neuroaxial Anesthesia Does Not Increase the Risk of Postoperative Low Back Pain after Herniorrhaphy

Chih-Chung Liu, Hsiao-Lun Sun, Yi-Hui Lee, Chih-Cheng Chien, Shung-Tai Ho

Research output: Contribution to journalArticle

Abstract

Background: Backache is a common complaint after spinal or epidural anesthesia. The causal relationship between anesthesia and postoperative low back pain is still debated. The aim of this investigation is to explore the association between neuroaxial anesthesia and post-operative low back pain in adult patients receiving herniorrhaphy by analyzing the National Health Insurance Research Database (NHIRD). Methods: The study is a retrospective cohort study. We analyzed the Longitudinal Health Insurance Database (LHID) which contains all the original claim data of 1,000,000 beneficiaries randomly sampled from all beneficiaries of Taiwan's NHIRD over the period 1998 to 2006. We screened all adult patients (older than 18 year old) who received epidural anesthesia or spinal anesthesia for inguinal herniorrhaphy or femoral herniorrhaphy as the study cohort. These patients were followed up to 1 year after surgery by the diagnosis of low back pain (defined by ICD-9-CM codes 720 to 724, exclude cervical and thoracic region). The comparison cohort was adult patients who received non-neuroaxial anesthesia for herniorrhaphy. Results: Total 5,457 adult patients received herniorrhaphy were screened from NHIRD, in which 4,455 patients received neuroaxial anesthesia and the other 1,002 patients didn't. During the one-year follow-up period, 161 (3.61%) of the neuroaxial anesthesia group and 37 (3.69%) of the control group developed acute low back pain. 387(8.69%) of the neuroaxial anesthesia group and 89(8.88%) of the control group developed chronic low back pain. The patients received neuroaxial anesthesia didn't increase their risk in developing postoperative acute (OR=0.943, 95% CI, 0.647-1.374) and chronic low back pain (OR=0.937, 95% CI, 0.729-1.203). Conclusions: To our knowledge, this is the first nationwide population-based study regarding the association of post-herniorrhaphy backache with neuroaxial anesthesia in Taiwan. Our data showed that neuroaxial anesthesia does not increase the risk of low back pain in adult patients after herniorrhaphy. History of low back pain increased the risk of developing low back pain after surgery.
Original languageEnglish
Pages (from-to)35-40
Number of pages6
Journal疼痛醫學雜誌
Volume21
Issue number2
DOIs
Publication statusPublished - 2011
Externally publishedYes

Fingerprint

Herniorrhaphy
Low Back Pain
Anesthesia
National Health Programs
Databases
Epidural Anesthesia
Spinal Anesthesia
Back Pain
Taiwan
Cohort Studies
Research
Control Groups
Groin
International Classification of Diseases
Health Insurance
Thigh
Thorax
Retrospective Studies

Keywords

  • 全民健保資料庫
  • 硬脊膜外麻醉
  • 脊髓麻醉
  • 下背痛
  • Low back pain
  • spinal anesthesia
  • epidural anesthesia
  • health insurance database

Cite this

Neuroaxial Anesthesia Does Not Increase the Risk of Postoperative Low Back Pain after Herniorrhaphy. / Liu, Chih-Chung; Sun, Hsiao-Lun; Lee, Yi-Hui; Chien, Chih-Cheng; Ho, Shung-Tai.

In: 疼痛醫學雜誌, Vol. 21, No. 2, 2011, p. 35-40.

Research output: Contribution to journalArticle

Liu, Chih-Chung ; Sun, Hsiao-Lun ; Lee, Yi-Hui ; Chien, Chih-Cheng ; Ho, Shung-Tai. / Neuroaxial Anesthesia Does Not Increase the Risk of Postoperative Low Back Pain after Herniorrhaphy. In: 疼痛醫學雜誌. 2011 ; Vol. 21, No. 2. pp. 35-40.
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title = "Neuroaxial Anesthesia Does Not Increase the Risk of Postoperative Low Back Pain after Herniorrhaphy",
abstract = "Background: Backache is a common complaint after spinal or epidural anesthesia. The causal relationship between anesthesia and postoperative low back pain is still debated. The aim of this investigation is to explore the association between neuroaxial anesthesia and post-operative low back pain in adult patients receiving herniorrhaphy by analyzing the National Health Insurance Research Database (NHIRD). Methods: The study is a retrospective cohort study. We analyzed the Longitudinal Health Insurance Database (LHID) which contains all the original claim data of 1,000,000 beneficiaries randomly sampled from all beneficiaries of Taiwan's NHIRD over the period 1998 to 2006. We screened all adult patients (older than 18 year old) who received epidural anesthesia or spinal anesthesia for inguinal herniorrhaphy or femoral herniorrhaphy as the study cohort. These patients were followed up to 1 year after surgery by the diagnosis of low back pain (defined by ICD-9-CM codes 720 to 724, exclude cervical and thoracic region). The comparison cohort was adult patients who received non-neuroaxial anesthesia for herniorrhaphy. Results: Total 5,457 adult patients received herniorrhaphy were screened from NHIRD, in which 4,455 patients received neuroaxial anesthesia and the other 1,002 patients didn't. During the one-year follow-up period, 161 (3.61{\%}) of the neuroaxial anesthesia group and 37 (3.69{\%}) of the control group developed acute low back pain. 387(8.69{\%}) of the neuroaxial anesthesia group and 89(8.88{\%}) of the control group developed chronic low back pain. The patients received neuroaxial anesthesia didn't increase their risk in developing postoperative acute (OR=0.943, 95{\%} CI, 0.647-1.374) and chronic low back pain (OR=0.937, 95{\%} CI, 0.729-1.203). Conclusions: To our knowledge, this is the first nationwide population-based study regarding the association of post-herniorrhaphy backache with neuroaxial anesthesia in Taiwan. Our data showed that neuroaxial anesthesia does not increase the risk of low back pain in adult patients after herniorrhaphy. History of low back pain increased the risk of developing low back pain after surgery.",
keywords = "全民健保資料庫, 硬脊膜外麻醉, 脊髓麻醉, 下背痛, Low back pain, spinal anesthesia, epidural anesthesia, health insurance database",
author = "Chih-Chung Liu and Hsiao-Lun Sun and Yi-Hui Lee and Chih-Cheng Chien and Shung-Tai Ho",
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T1 - Neuroaxial Anesthesia Does Not Increase the Risk of Postoperative Low Back Pain after Herniorrhaphy

AU - Liu, Chih-Chung

AU - Sun, Hsiao-Lun

AU - Lee, Yi-Hui

AU - Chien, Chih-Cheng

AU - Ho, Shung-Tai

PY - 2011

Y1 - 2011

N2 - Background: Backache is a common complaint after spinal or epidural anesthesia. The causal relationship between anesthesia and postoperative low back pain is still debated. The aim of this investigation is to explore the association between neuroaxial anesthesia and post-operative low back pain in adult patients receiving herniorrhaphy by analyzing the National Health Insurance Research Database (NHIRD). Methods: The study is a retrospective cohort study. We analyzed the Longitudinal Health Insurance Database (LHID) which contains all the original claim data of 1,000,000 beneficiaries randomly sampled from all beneficiaries of Taiwan's NHIRD over the period 1998 to 2006. We screened all adult patients (older than 18 year old) who received epidural anesthesia or spinal anesthesia for inguinal herniorrhaphy or femoral herniorrhaphy as the study cohort. These patients were followed up to 1 year after surgery by the diagnosis of low back pain (defined by ICD-9-CM codes 720 to 724, exclude cervical and thoracic region). The comparison cohort was adult patients who received non-neuroaxial anesthesia for herniorrhaphy. Results: Total 5,457 adult patients received herniorrhaphy were screened from NHIRD, in which 4,455 patients received neuroaxial anesthesia and the other 1,002 patients didn't. During the one-year follow-up period, 161 (3.61%) of the neuroaxial anesthesia group and 37 (3.69%) of the control group developed acute low back pain. 387(8.69%) of the neuroaxial anesthesia group and 89(8.88%) of the control group developed chronic low back pain. The patients received neuroaxial anesthesia didn't increase their risk in developing postoperative acute (OR=0.943, 95% CI, 0.647-1.374) and chronic low back pain (OR=0.937, 95% CI, 0.729-1.203). Conclusions: To our knowledge, this is the first nationwide population-based study regarding the association of post-herniorrhaphy backache with neuroaxial anesthesia in Taiwan. Our data showed that neuroaxial anesthesia does not increase the risk of low back pain in adult patients after herniorrhaphy. History of low back pain increased the risk of developing low back pain after surgery.

AB - Background: Backache is a common complaint after spinal or epidural anesthesia. The causal relationship between anesthesia and postoperative low back pain is still debated. The aim of this investigation is to explore the association between neuroaxial anesthesia and post-operative low back pain in adult patients receiving herniorrhaphy by analyzing the National Health Insurance Research Database (NHIRD). Methods: The study is a retrospective cohort study. We analyzed the Longitudinal Health Insurance Database (LHID) which contains all the original claim data of 1,000,000 beneficiaries randomly sampled from all beneficiaries of Taiwan's NHIRD over the period 1998 to 2006. We screened all adult patients (older than 18 year old) who received epidural anesthesia or spinal anesthesia for inguinal herniorrhaphy or femoral herniorrhaphy as the study cohort. These patients were followed up to 1 year after surgery by the diagnosis of low back pain (defined by ICD-9-CM codes 720 to 724, exclude cervical and thoracic region). The comparison cohort was adult patients who received non-neuroaxial anesthesia for herniorrhaphy. Results: Total 5,457 adult patients received herniorrhaphy were screened from NHIRD, in which 4,455 patients received neuroaxial anesthesia and the other 1,002 patients didn't. During the one-year follow-up period, 161 (3.61%) of the neuroaxial anesthesia group and 37 (3.69%) of the control group developed acute low back pain. 387(8.69%) of the neuroaxial anesthesia group and 89(8.88%) of the control group developed chronic low back pain. The patients received neuroaxial anesthesia didn't increase their risk in developing postoperative acute (OR=0.943, 95% CI, 0.647-1.374) and chronic low back pain (OR=0.937, 95% CI, 0.729-1.203). Conclusions: To our knowledge, this is the first nationwide population-based study regarding the association of post-herniorrhaphy backache with neuroaxial anesthesia in Taiwan. Our data showed that neuroaxial anesthesia does not increase the risk of low back pain in adult patients after herniorrhaphy. History of low back pain increased the risk of developing low back pain after surgery.

KW - 全民健保資料庫

KW - 硬脊膜外麻醉

KW - 脊髓麻醉

KW - 下背痛

KW - Low back pain

KW - spinal anesthesia

KW - epidural anesthesia

KW - health insurance database

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DO - 10.29792/TTJP.201109.0001

M3 - Article

VL - 21

SP - 35

EP - 40

JO - 疼痛醫學雜誌

JF - 疼痛醫學雜誌

SN - 1021-7959

IS - 2

ER -