ArticleJournal of anesthesia2026
Effect of preoperative anxiety on acute post-spinal low back pain after cesarean delivery: a prospective cohort study.
Article in Journal of anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeWhile multiple factors contribute to acute post-spinal low back pain (LBP), the role of preoperative anxiety in obstetric patients remains unclear. This prospective study investigated the association between preoperative anxiety and acute post-spinal LBP following cesarean delivery (CD).
methodsPatients undergoing elective (category 4) or non-elective (categories 2 and 3) CD under spinal anesthesia were enrolled. Preoperative anxiety was defined as an Amsterdam Preoperative Anxiety and Information Scale score ≥ 11. The primary outcome was the incidence of acute post-spinal LBP during movement at 24 h after surgery. Based on LBP scores, patients were categorized into no-to-mild pain (Numeric Rating Scale [NRS] 0-3) and moderate-to-severe pain (NRS ≥ 4). Logistic regression was used to identify risk factors for the incidence and presence of moderate-to-severe acute post-spinal LBP.
resultsAmong 295 patients analyzed, 78 (26%) had preoperative anxiety. Acute post-spinal LBP during movement at 24 h occurred in 42 patients (14%). Pre-existing LBP (odds ratio [OR] 3.37, 95% confidence interval [CI] 1.61-7.06; P = 0.001) and delayed post-delivery ambulation (OR 1.26, 95% CI 1.09-1.46; P = 0.002) were associated with the overall incidence of acute post-spinal LBP. Predictors of moderate-to-severe pain were preexisting LBP (OR 3.88, 95% CI 1.33-11.28; P = 0.013), preoperative anxiety (OR 3.50, 95% CI 1.24-9.84; P = 0.017), and delayed post-delivery ambulation (OR 1.47, 95% CI 1.17-1.85; P = 0.001).
conclusionPreoperative anxiety was not associated with the incidence of acute post-spinal LBP but independently predicted moderate-to-severe pain. Pre-existing LBP and delayed post-delivery ambulation were also independent predictors of moderate-to-severe acute post-spinal LBP.
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