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頁籤選單縮合
| 題 名 | Neuroaxial Anesthesia Does Not Increase the Risk of Postoperative Low Back Pain after Herniorrhaphy=半身麻醉不會增加術後下背痛的風險 |
|---|---|
| 作 者 | 劉志中; 孫孝倫; 李怡慧; 簡志誠; 何善台; | 書刊名 | 疼痛醫學雜誌 |
| 卷 期 | 21:2 2011.09[民100.09] |
| 頁 次 | 頁35-40 |
| 分類號 | 416.54 |
| 關鍵詞 | 全民健保資料庫; 硬脊膜外麻醉; 脊髓麻醉; 下背痛; Low back pain; Spinal anesthesia; Epidural anesthesia; Health insurance database; |
| 語 文 | 英文(English) |
| 中文摘要 | 背景及目的:半身麻醉後發生下背痛是臨床上常見的問題。但是半身麻醉是否會引起術後下背痛則是尚待釐清的議題。本研究的目的是利用全民健保資料庫來分析,進行疝氣修補術的成年病人中,接受半身麻醉是否會增加術後發生下背痛的風險。研究設計:本研究採用1998-2006年,全民健保資料庫100 萬人隨機抽樣歸人檔,篩選出接受疝氣修補術的成年病患,再依照其麻醉方式分為半身麻醉和非半身麻醉兩組病人,術後追蹤一年,比較追蹤期間內因慢性下背痛就醫的比率是否有差異,並比較可能的影響因子。實驗結果:從全民健保資料庫中,共篩選出5 , 457位接受疝氣修補手術的成年病人,其中接受半身麻醉的成年病患有4 , 455人,接受非半身麻醉的病人有1 , 002 位。追蹤術使一年發現,半身麻醉並末增加病人手術後發生急性下背痛(Odds Ratio= 0.943 , 95% 口,0.647-1.374) 與慢性下背痛(OR= 0.937 , 95% 口, O. 729-l. 203) 的風險。另外我們發現手術前一年內曾發生過下背痛的病患,術後發生下背痛的風險較高(P<0.0001) 。研究結論:本研究顯示,成年病患接受疝氣修補手術,半身麻醉並不會增加術後下背痛的發生風險;有下背痛病史的病人,掉了後發生下背痛的風險較高. |
| 英文摘要 | Background: Backache is a common complaint after spinal or epidural anesthesia. The causal relationship between anesthesia postoperative low back pain is still debated. The aim of this investigation is to explore the association between neuroaxial anesthesia and post-operative low back pain in adult patients receiving hemiorrhaphy by analyzing the National Health Insurance Research Database (NHIRD).Methods: The study is a retrospective cohort study. We analyzed the Longitudinal Health Insurance Database (LHID) which contains a11 the original claim data of1,000,000 beneficiaries randomly sampled from all beneficiaries of Taiwan's NHIRD over the period 1998 to 2006. We screened a11 adult patientS (older than 18 year old)who received epidural anesthesia or spinal anesthesia for inguinal herniorrhaphy or femoral herniorrhaphy as the study cohort. These patìents were followed up to 1 year after surgery by the diagnosis of low back pain (defined by ICD-9-CM codes 720 to 724, exclude cervical and thoracic region). The comparison cohort was adult patients who received non-neuroaxial anesthesia for herniorrhaphy. Results: Total 5,457 adult patients received herniorrhapby were screened from NHIRD, in which 4,455 patients received neuroaxial anesthesia and the other 1,002 patients didn’t. During the one-year follow-up period, 161 (3.61%) ofthe neuroaxialanesthesia group and 37 (3.69%) of the control group developed acute low back pain‘387(8.69%) of the neuroaxial anesthesia group and 89(8.88%) of the control group developed chronic low back pain. The patients received neuroaxial anesthesia didn't tincrease their risk in developing postoperative acute (OR=0.943, 95% CI, 0.647-1 .374)and chronic low back pain (OR=0.937, 95% CI, 0.729-1.203).Conclusions: To our knowledge, this is the first nationwide population-based studyregarding the association of post-herniorrhaphy backacbe with neuroaxial anesthesia inTaiwan. Our data showed that neuroaxial anesthesia does not increase the risk of lowback pain in adult patients after herniorrhaphy. History of low back pain Ïncreased therisk of developing low back pain after surgery. |
本系統中英文摘要資訊取自各篇刊載內容。