Epidural analgesia and backache: a randomized controlled comparison with intramuscular meperidine for analgesia during labour.
BACKGROUND
Concern has been expressed that epidural analgesia for labour may be associated with a higher incidence of backache.


METHODS
A prospective randomized trial investigating the effect of epidural analgesia on the outcome of labour in nulliparae, mothers were randomized to receive either epidural analgesia or meperidine. A questionnaire on postnatal symptoms was sent to them 6 months after delivery.


RESULTS
In all, 611 mothers were studied; 310 were randomly allocated to receive i.m. meperidine up to 300 mg and 301 to receive epidural bupivacaine. The response rate to our questionnaire was 83%. Intention-to-treat analysis showed similar prevalence rates of postpartum backache in the epidural (48%) and meperidine groups (50%), with an observed difference (epidural-meperidine) of -2% (95% CI, -11 to +6%). After excluding mothers with backache before delivery, there were also similar incidence rates of postpartum backache in the epidural (29%) and meperidine groups (28%), observed difference 1% (95% CI, -8 to +10%).


CONCLUSIONS
Epidural analgesia in labour was not associated with an increase in the prevalence or incidence of backache.
Loughnan
B A
BA
Departments of Anaesthesia and Obstetrics and Gynaecology, Northwick Park Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, UK.
Carli
F
F
Romney
M
M
Doré
C J
CJ
Gordon
H
H
D015360:Analgesia, Epidural / Q000009:adverse effects*; D016362:Analgesia, Obstetrical / Q000009:adverse effects* / Q000379:methods; D000701:Analgesics, Opioid; D001416:Back Pain / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008614:Meperidine; D007744:Obstetric Labor Complications / Q000209:etiology* / Q000517:prevention & control; D010147:Pain Measurement; D011247:Pregnancy; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000209:etiology; D011795:Surveys and Questionnaires
D000701:Analgesics, Opioid; D008614:Meperidine