Incidence and Factors Associated with Back Pain among Patients Undergoing Spinal Anesthesia in University of Gondar Comprehensive and Specialized Hospital, North West Ethiopia, 2020

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