Abstract:
Abstract
Background: Back pain is often reported as a common complaint after surgery. Many studies
showed that the incidence after spinal anesthesia is high and its magnitude is considerable in
developing countries, and it is highly related with reduced quality of life, loss of work
productivity, burden of health care costs and satisfaction regarding health care service, therefore
measures should be taken to reduce or prevented post spinal back. But, before this, assessing the
incidence with its associated factors is important.
Objective: To assess the incidence and factors associated with back pain among patients
undergoing spinal anesthesia in University of Gondar Comprehensive and Specialized Hospital
from March - May, 2020.
Methodology: An institutional based cross sectional study was conducted in University of
Gondar Comprehensive and Specialized Hospital, after obtained an ethical clearance school of
medicine ethical review committee. A total of 215 voluntary participants were enrolled. A binary
and Multivariable logistic regression model was used to determine independent predictors of post
spinal back pain and 95% CI were computed to see the association with p-value < 0.05.
Results: The overall incidence of post spinal back pain was 40.5% (CI: 34.0, 47.4). The
likelihood of developing post spinal back pain was BMI > 25 kg/m2 (AOR=3.8; CI: 1.47, 9.96),
and in BMI > 30 kg/m2 (AOR=4.9; CI: 1.19, 20.4) than patients with < 25 kg/m2 BMI (p<0.05).
Used of a big spinal needles (18-22G) (AOR=5.9; CI: 1.04, 33.4) than smaller needles (23-29G).
An attempt of lumbar puncture twice (AOR=5.5; CI: 1.74, 17.59) and attempt of ? 3 times of
lumbar puncture during SA (AOR=4.9; CI: 1.63, 15.2) more likely to develop PSBP than
patients had only a single lumbar puncture attempt. A single bone contact during intervention
(AOR=3.1; CI: 1.14, 8.45) and ? 2 times of bone contact during the procedure (AOR=7.6; CI:
2.6, 22.4) more likely to develop post spinal back pain than patients had no any bone contact.
Conclusion and recommendation: The overall incidence of back pain is high compared to
studies done previously. BMI, size of spinal needle, number of attempt and number of bone
contact are predictors for the incidence of back pain following spinal anesthesia. Reducing the
number of attempts & bone contacts during lumbar puncture and choosing smaller spinal needle
needles, to prevent or at least reduce the incidence of post spinal back pain.
Key words: Incidence, associated factors, Post spinal back pain and spinal anesthesia
