Abstract:
OBJECTIVE:To examine the association between obstetric epidural anaesthesia and subsequent long term problems. DESIGN:Postal questionnaire on health problems after childbirth linked to maternity case note data. SETTING:Maternity hospital in Birmingham. SUBJECTS:11701 women who delivered their most recent child during 1978-85 and who returned completed questionnaires. MAIN OUTCOME MEASURES:Frequencies of long term symptoms after childbirth. RESULTS:Compared with the 6935 women who did not have epidural anaesthesia the 4766 women who did more commonly experienced backache (903 (18.9%) with epidural v 731 (10.5%) without epidural), frequent headaches 220 (4.6%) v 199 (2.9%)), migraine (92 (1.9%) v 73 (1.1%)), neckache (116 (2.4%) v 112 (1.6%)), and tingling in hands or fingers (143 (3.0%) v 150 (2.2%)). The results could not be explained by correlated social or obstetric factors. The associations with head, neck, and hand symptoms were found only in women who reported backache. An excess of visual disturbances among women who had epidural anaesthesia (83 (1.7%) v 91 (1.3%)) was present only in association with migraine, but excess of dizziness or fainting (102 (2.1%) v 109 (1.6%)) was independent of other symptoms. 26 women had numbness or tingling in the lower back, buttocks, and leg, of whom 23 had had epidural anaesthesia. Of 34 women with spinal headache, nine (five after accidental dural puncture; four after spinal block) reported long term headaches. CONCLUSIONS:These associations may indicate a causal sequence, although this cannot be proved from this type of study. Randomised trials of epidural anaesthesia are required to determine whether causal relations exist.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
MacArthur C,Lewis M,Knox EGdoi
10.1136/bmj.304.6837.1279keywords:
subject
Has Abstractpub_date
1992-05-16 00:00:00pages
1279-82issue
6837eissn
0959-8138issn
1756-1833journal_volume
304pub_type
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.39203.658970.55
更新日期:2007-06-16 00:00:00
abstract:OBJECTIVE:To test the hypothesis that hydroxymethyl glutaryl coenzyme A reductase inhibitors (statins) may decrease the risk of community acquired pneumonia. DESIGN:Population based case-control study. SETTING:Group Health, a large integrated healthcare delivery system. Population Immunocompetent, community dwelling ...
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1136/bmj.319.7208.483
更新日期:1999-08-21 00:00:00
abstract:OBJECTIVE:To undertake a cost effectiveness analysis comparing first and second generation endometrial ablative techniques, hysterectomy, and the levonorgestrel releasing intrauterine system (Mirena) for treating heavy menstrual bleeding. DESIGN:Model based economic evaluation with data from an individual patient data...
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更新日期:2011-04-26 00:00:00
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更新日期:1990-01-06 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.i2375
更新日期:2016-05-17 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2012-06-06 00:00:00
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更新日期:1989-04-15 00:00:00
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pub_type: 杂志文章,meta分析
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更新日期:1998-03-14 00:00:00
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更新日期:2014-11-11 00:00:00
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更新日期:2011-06-30 00:00:00
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更新日期:1990-07-28 00:00:00
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pub_type: 历史文章,杂志文章
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更新日期:1995-12-23 00:00:00
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更新日期:1994-09-17 00:00:00
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更新日期:2013-07-23 00:00:00
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更新日期:2011-06-07 00:00:00
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更新日期:1999-10-02 00:00:00
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更新日期:2012-05-30 00:00:00