Radiating pain during epidural needle insertion and catheter placement cannot be associated with postoperative persistent paresthesia: a retrospective review

JA Clinical Reports

Taichi Kotani¹  Keiko Uemura¹  Masahiko Kawaguchi¹  Satoki Inoue² 

[1] Department of Anesthesiology and Division of Intensive Care, Nara Medical University, 840 Shijo-cho Kashihara, 634-8522, Nara, Japan;Department of Anesthesiology, Fukushima Medical University, 1 Hikarigaoka, 960-1295, Fukushima, Fukushima, Japan;

关键词: Epidural anesthesia;    Radiating pain;    Paresthesia;   

DOI  :  10.1186/s40981-021-00460-w

来源: Springer

【 摘 要 】

BackgroundIt has been suggested that radiating pain during spinal or epidural needle insertion and catheter placement can be an indicator of needle-related nerve injury. In this study, using a historical cohort, we investigated what factors could be associated with postoperative persistent paresthesia. In addition, we focused on radiating pain during epidural needle insertion and catheterization.MethodsThis was a retrospective review of an institutional registry containing 21,606 anesthesia cases. We conducted multivariate logistic analysis in 2736 patients, who underwent epidural anesthesia, using the incidence of postoperative persistent paresthesia as a dependent variable and other covariates, including items of the anesthesia registry and the postoperative questionnaire, as independent variables in order to investigate the factors that were significantly associated with the risk of persistent paresthesia.ResultsOne hundred and seventy-six patients (6.44%) were found to have persistent paresthesia. Multivariate analysis revealed that surgical site at the extremities (odds ratio (OR), 12.5; 95% confidence interval (CI), 2.77–56.4; the reference was set at abdominal surgery), duration of general anesthesia (per 10 min) (OR, 1.02; 95% CI, 1.01–1.03), postoperative headache (OR, 1.78; 95% CI, 1.04–2.95), and days taken to visit the consultation clinic (OR, 1.03; 95% CI, 1.01–1.06) were independently associated with persistent paresthesia. Radiating pain was not significantly associated with persistent paresthesia (OR, 1.56; 95% CI, 0.69–3.54).ConclusionRadiating pain during epidural procedure was not statistically significantly associated with persistent paresthesia, which may imply that this radiating pain worked as a warning of nerve injury.

【 授权许可】

CC BY