Randomized Control Study for Evaluation of Effectiveness of Topical NSAIDS Patches to Prevent Backache Following Spinal Anesthesia in Caesarean Section

Abstract

Background: Women who had caesarean section (CS) with spinal anaesthesia had more chances to develop low back pain. Controlled studies evaluating the prevention of back pain after neuraxial anaesthesia involved mostly the use of an anti-inflammatory medication or steroid, given epidurally or as part of the intradermal injectate. The purpose of this study is to determine the effect of topical Nonsteroidal Anti-inflammatory drugs (NSAIDS) patch on decreasing the incidence of post-operative backache following spinal anaesthesia for caesarean section. Patients and methods: One hundred thirty parturients aged 19 -40 years, American society of Anaesthesiology class I & II scheduled for elective caesarean section with spinal anaesthesia were divided randomly into two equal Groups (65 patients each): ketoprofen group (TDK) received 30 mg ketoprofen transdermal patch at site of puncture for 24 hours and control group (TDC) received a placebo transdermal patch at site of puncture for 24 hours. In the Postoperative period 24 hours after the spinal procedure, the transdermal patch was removed in both groups then symptoms of back pain have been determined by visual numerical scale (VNS). Results: regard incidence of occurrence and severity of back pain (VNS > 3) the results showed that the back pain was less in the TDK group than in the TDC group at 24 hours post spinal interval (4.6% vs 15.4%) respectively. On the other hand there was no statistical significant difference at 48 hours and 2 weeks post spinal interval. Conclusion: Prophylactic application of topical NSAIDS patch may reduce the incidence and the severity of short term backache after spinal anaesthesia in CS with negligible complications.