Local supplementation of ketoprofen reduces the incidence of low back pain after lumbar epidural anesthesia.
BACKGROUND
Backache is a common postoperative complaint after lumbar epidural anesthesia. Our study was aimed to compare the effect of the local addition of ketoprofen on the incidence of postepidural backache after nonobstetric surgery.


METHODS
One thousand patients scheduled for hemorrhoidectomy were randomly given 4 ml of 1% lidocaine with ketoprofen 1:400 (ketoprofen group) or without ketoprofen (control group) for local skin infiltration prior to epidural needle placement. Each of them received a single epidural injection of 25 ml 2% lidocaine with epinephrine 1:200000, and was interviewed 24, 48, and 72 hours postoperatively using a standard visual analog scale (VAS) for evaluation of postepidural backache.


RESULTS
The incidence of postepidural backache in the ketoprofen-group patients for the 3 days was 9.8%, 4.6%, and 1.8%, all rates which were significantly less than those observed in the control-group patients (22.8%, 17.4%, and 9.2%, p < 0.001). There was also a significant association between postepidural backache and multiple attempts at epidural needle insertion.


CONCLUSIONS
In summary, the local addition of ketoprofen reduced the incidence and severity of postepidural backache.
Hsieh
J R
JR
Department of Anesthesia, Chang Gung Memorial Hospital, Keelung, Taipei, Taiwan, R.O.C.
Hui
Y L
YL
Yu
C C
CC
Lau
W M
WM
Ng
Y T
YT
Wang
Y L
YL
D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001416:Back Pain / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006484:Hemorrhoids / Q000601:surgery; D006801:Humans; D015994:Incidence; D007660:Ketoprofen / Q000008:administration & dosage*; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007660:Ketoprofen; D008012:Lidocaine