Comparison of Severity of Lower Back Pain Among Parturient Who Deliver by Cesarean Section Under Spinal Anesthesia Versus General Anesthesia at Gandhi Memorial Hospital Addis Ababa, Ethiopia, 2022/23

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Addis Ababa University


Lower back pain is a pain at lumbar region, above the sacrum. It is characterized as a dull aching pain which is associated with restriction in spine movement. Globally it is a common complaint during pregnancy and also after delivery. It is still controversial whether spinal or general anesthesia for cesarean section is associated with lower back pain. Considering the increase in cesarean section rates in recent years and the negative impact of this kind of pain on a mother, assessing lower back pain with types of anesthesia delivered will enable to fill the gap in awareness and creates better clinical management strategies. OBJECTIVES: To compare severity of lower back pain among parturient who deliver by cesarean section under spinal anesthesia versus general anesthesia at Gandhi memorial specialized hospital Addis Ababa, Ethiopia, 2022/23. METHOD: An institutional based prospective follow up study was conducted in 80 parturient who deliver with cesarean section under spinal or general anesthesia at Gandhi memorial hospital from December 30 2022, to April 30, 2023. Consecutive sampling technique was used. Data was collected by a pretested questionnaire started from 1st 24 hours postoperative delivery by direct contact and through telephonic communication every week for 1 month. Numeric rating score was used to evaluate the severity of lower back pain. Proportion (incidence) of lower back pain was calculated. Normal distributed variable was compared by using the independent t test. Mann Whitney U test was used for non-normal distributed data. Chi-square test was used to compare the categorical data. A P value of less than 0.05 is considered to indicate statistical significance. RESULT: The overall incidence of lower back pain was 81.25%. Out of 40 parturient under spinal anesthesia group, 34(85%) develop lower back pain whereas under general anesthesia, 31(77.25%) develop lower back pain. Mann Whitney U test show median pain score difference between groups at 24 hour and 1st week after delivery with P value (0.034,0.005) respectively. Age was associated with lower back pain in spinal groups (p value 0.031). Parity and lower back pain during pregnancy were associated with lower back pain in general groups (p value 0.037,0.016). CONCLUSION: The incidence of lower back pain was high both in parturient with spinal and general anesthesia groups. There was significant difference in pain score among the two groups at 24 hour and first week. Age, parity and history of lower back pain during pregnancy were associated with the incidence of lower back