[Low back pain and headache during immediate postpartum. Role of obstetrical epidural analgesia].
The rate of low back pain and headache following parturition seems to be higher in patients delivered under epidural analgesia. The aim of this study, performed in the immediate postpartum (up to 3rd day) and including 200 patients delivered vaginally, was to assess the incidence and the risk factors of low back pain and headache. A total of 31.5% of them complained of low back pain (LBP+) after parturition. They were significantly younger than those without low back pain (LBP-) (p < 0.03) and have had significantly more often epidural analgesia (p < 0.05). However, there were no statistically significant differences concerning weight, weight gain, parity, duration of labour and duration of epidural analgesia. The LBP+ patients complained significantly more often of cervical (p < 0.04) and low back pain (p < 0.02) during pregnancy, than the LBP-. In the immediate postpartum period, cervical and dorsal pain as well as headache occurred significantly more often in LBP+ than in LBP+ (p < 0.001). The intensity of low back pain during pregnancy (p < 0.006). Risk factors for postpartum LBP were epidural analgesia (OR = odds ratio = 6.59), LBP (OR = 6.50) and cervical pain (OR = 2.75) during pregnancy. The influence of epidural analgesia is questionable, as there was no difference between duration of labour and duration of epidural analgesia, if used, between the two groups. Patients for whom epidural analgesia was required are probably more susceptible to pain during pregnancy. Patients who suffered from postpartum headache (PPHDA+) were comparable to those who did not (PPDHA-).(ABSTRACT TRUNCATED AT 250 WORDS)
Palot
P
P
Département d'Anesthésie-Réanimation, CHU, Reims.
Jolly
D H
DH
Visseaux
H
H
Botmans
C
C
Abdi
M
M
Gabriel
R
R
Pire
J C
JC
D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects*; D016362:Analgesia, Obstetrical / Q000009:adverse effects*; D005260:Female; D006261:Headache / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology / Q000209:etiology*; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications; D012307:Risk Factors
Douleurs lombaires et céphalées dans le postpartum immédiat. Rôle de l'analgésie péridurale obstétricale.