Risk factors for post-spinal anesthesia headache and low back pain after orthopedic lower limb surgery in obese patients in Shohada hospital of Tabriz

Abstract

Introduction: The various factors affecting the incidence of post-spinal anesthesia low back pain and headache, such as high body mass index (BMI), the anesthesiologist’s expertise, and spinal needle gauge, make it impossible to adequately plan preventive measures. Objectives: This study aimed to determine the risk factors for post-spinal anesthesia headache and low back pain after orthopedic lower limb surgery in obese patients in Shohada hospital of Tabriz, Iran. Patients and Methods: This descriptive cross-sectional and prospective study was conducted on 200 obese candidates for lower limb surgery under spinal anesthesia in 2019. An anesthesiologist used a 25-gauge needle to induct spinal anesthesia for evaluating the incidence of post-spinal anesthesia headache, low back pain, and their risk factors. Results: The incidence of post-spinal anesthesia headache in obese participants was 6.5% on the first day, 3.5% in the first week, and 1% in the first month; whereas the incidence of low back pain was 16% on the first day, 9% in the first week, and 3.5% in the first month. Postoperative headache and low back pain exhibited a significant correlation with the history of spinal anesthesia and low back pain; therefore, they were found as the main risk factors for these complications. Conclusion: This study found lower post-spinal anesthesia headache and low back pain than in previous studies, which decreased further over time. Skilled anesthesiologists are recommended to use a small-gauge needle to induct spinal anesthesia to participants with a history of spinal anesthesia and low back pain.