Abstract：
BACKGROUND: The development of back pain following epidural analgesia is one reason for patient refusal of neuraxial analgesia. The primary endpoint of this study was to compare the incidence and severity of back pain following midline and paramedian epidural technique. The secondary endpoint was to identify the risk factors associated with the occurrence of back pain.
METHODS: This prospective randomized study included 114 patients receiving thoracic epidural catheterization for pain management following upper abdominal or thoracic surgery. Patients were allocated to either the midline or the paramedian group by computer-generated randomization. An investigator who was blinded to the patient group interviewed patients at 24, and 48 h, and 3-5 days after surgery about the existence of back pain and its severity.
RESULTS: The total incidence of back pain following epidural anesthesia was 23.8% in the midline group and 7.8% in the paramedian group. The numerical rating scale of back pain was not different between the two groups at 24 h and 4 days after surgery. The paramdian technique was associated with a lower incidence of back pain than the midline technique (95% confidence interval 0.05-0.74, odds ratio 0.2, P < 0.01). However, the number of attempts, surgical position, body mass index, and duration of surgery were not associated with back pain.
CONCLUSIONS: This study showed that the midline group of thoracic epidural analgesia demonstrated higher incidence of back pain than the paramedian group. However, the pain was mild in intensity and decreased with time in both groups.
METHODS: This prospective randomized study included 114 patients receiving thoracic epidural catheterization for pain management following upper abdominal or thoracic surgery. Patients were allocated to either the midline or the paramedian group by computer-generated randomization. An investigator who was blinded to the patient group interviewed patients at 24, and 48 h, and 3-5 days after surgery about the existence of back pain and its severity.
RESULTS: The total incidence of back pain following epidural anesthesia was 23.8% in the midline group and 7.8% in the paramedian group. The numerical rating scale of back pain was not different between the two groups at 24 h and 4 days after surgery. The paramdian technique was associated with a lower incidence of back pain than the midline technique (95% confidence interval 0.05-0.74, odds ratio 0.2, P < 0.01). However, the number of attempts, surgical position, body mass index, and duration of surgery were not associated with back pain.
CONCLUSIONS: This study showed that the midline group of thoracic epidural analgesia demonstrated higher incidence of back pain than the paramedian group. However, the pain was mild in intensity and decreased with time in both groups.
摘要：
背景：硬膜外镇痛后背痛的发展是患者拒绝神经轴镇痛的原因之一。这项研究的主要终点是比较中线和旁中硬膜外技术后背痛的发生率和严重程度。次要终点是确定与背痛发生相关的危险因素。
方法：这项前瞻性随机研究纳入了114例患者，这些患者在上腹部或胸部手术后接受了胸段硬膜外置管治疗疼痛。通过计算机生成的随机化将患者分配到中线或参数组。一名对患者组不知情的研究者在24小时和48小时采访了患者，以及手术后3-5天关于背痛的存在及其严重程度。
结果：硬膜外麻醉后背痛的总发生率在中线组为23.8%，在副行组为7.8%。术后24h和4天，两组之间的背痛数字评分无差异。paramdian技术与中线技术相比，背痛的发生率较低（95％置信区间0.05-0.74，比值比0.2，P<0.01）。然而,尝试的次数,手术位置,身体质量指数,手术时间与背痛无关.
结论：这项研究表明，胸段硬膜外镇痛中线组的背痛发生率高于副行组。然而,两组患者的疼痛强度均较轻,且随时间延长而减轻.
方法：这项前瞻性随机研究纳入了114例患者，这些患者在上腹部或胸部手术后接受了胸段硬膜外置管治疗疼痛。通过计算机生成的随机化将患者分配到中线或参数组。一名对患者组不知情的研究者在24小时和48小时采访了患者，以及手术后3-5天关于背痛的存在及其严重程度。
结果：硬膜外麻醉后背痛的总发生率在中线组为23.8%，在副行组为7.8%。术后24h和4天，两组之间的背痛数字评分无差异。paramdian技术与中线技术相比，背痛的发生率较低（95％置信区间0.05-0.74，比值比0.2，P<0.01）。然而,尝试的次数,手术位置,身体质量指数,手术时间与背痛无关.
结论：这项研究表明，胸段硬膜外镇痛中线组的背痛发生率高于副行组。然而,两组患者的疼痛强度均较轻,且随时间延长而减轻.
