Anesthesia & Analgesia, Vol 85, 1066-1070, Copyright © 1997 by International Anesthesia Research Society

GENERAL ARTICLES

Is epidural anesthesia in labor associated with chronic low back pain? A prospective cohort study

AJ Macarthur, C Macarthur and SK Weeks
Department of Anesthesia, University of Calgary, Alberta, Canada.

The association between epidural anesthesia during labor and subsequent postpartum low back pain remains unclear. The objective of this follow- up cohort study was to determine whether epidural anesthesia was associated with chronic back pain 1 yr after delivery. We contacted 329 women by telephone and asked them to complete a standardized questionnaire 1 yr (+/-1 mo) after delivery. One hundred sixty-four women had received epidural analgesia for labor and delivery, and 165 had not. Subjects were asked to quantify their back pain (yes/no, numeric rating score, and interference with daily activities). Differences between the two groups were tested by using the chi2 test and the Mann-Whitney U-test, and logistic regression was used to control for confounding variables. The response rate was 244 of 329 (74%). Responders and nonresponders were similar in their demographic and clinical characteristics. There was no difference in the prevalence of back pain between women who had received epidural anesthesia (12 of 121, 10%) and those who had not (17 of 123, 14%). The adjusted relative risk of low back pain at 1 yr (epidural versus nonepidural) was 0.63 (95% confidence interval 0.25, 1.56). There were also no differences between the two groups on numeric rating scores or level of interference with activities. This prospective follow-up study demonstrated no association between epidural anesthesia for labor and delivery and chronic back pain 1 yr after delivery. IMPLICATIONS: We evaluated the presence of low back pain 1 yr after delivery in two groups of women-those who chose epidural analgesia for labor and those who did not. There was no increased risk of back pain in women who had used epidural analgesia. This finding is consistent with those of other North American studies.

This article has been cited by other articles:

				J. A. Copel Born in the USA: How a Broken Maternity System Must Be Fixed To Put Women and Children First JAMA, April 18, 2007; 297(15): 1718 - 1719. [Full Text] [PDF]

				H. K. Eltzschig, E. S. Lieberman, and W. R. Camann Regional Anesthesia and Analgesia for Labor and Delivery N. Engl. J. Med., January 23, 2003; 348(4): 319 - 332. [Full Text] [PDF]

				C. J Howell, T. Dean, L. Lucking, K. Dziedzic, P. W Jones, and R. B Johanson Randomised study of long term outcome after epidural versus non-epidural analgesia during labour BMJ, August 17, 2002; 325(7360): 357 - 357. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999