Intraprocedural Back Pain Associated with Awake Neuroendovascular Procedures

J Neuroimaging. 2021 Jan;31(1):209-214. doi: 10.1111/jon.12801. Epub 2020 Nov 11.

Abstract

Background and purpose: The prevalence and characteristics of intraprocedural back pain is not well studied in awake patients undergoing neuroendovascular procedures.

Methods: We performed a prospective study as part of quality improvement initiative in which all patients who underwent neuroendovascular procedures in awake state were inquired regarding presence, severity (using a numeric rating scale score ranging from 0 [no pain] to 10 [worst pain possible]), and location (using anatomical chart) of back pain immediately after the procedure. The primary endpoint was the proportion of patients with moderate to severe pain (score of ≥3).

Results: A total of 100 (41.3%) of 242 patients reported intraprocedural back pain with a median severity of 5/10 (range 1-10). The mean age was 58.7 ± 16.2 years. The mean duration of the procedure was 82.3 minutes (range 15-410 minutes). The pain was classified as moderate to severe in 86 of 100 patients. The locations of pain were identified in lumbar (n = 77), thoracic (n = 6), cervical (n = 7), cervical and lumbar (n = 8), and cervical with thoracolumbar (n = 2) regions. There was a significant relationship between patients' history of the previous neck and/or back surgery and frequency of moderate to severe back pain (P = .02). No significant relationship was observed between frequency of none to mild and moderate to severe back pain among the strata by patients' age, body mass index, or duration of procedures.

Conclusions: The relatively high prevalence of intraprocedural back pain in patients undergoing neuroendovascular procedures in awake state must be recognized, and strategies to reduce the occurrence need to be identified.

Keywords: Analgesics; back pain; cerebral angiography; neck pain; neuroendovascular procedures.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Back Pain / etiology*
  • Endovascular Procedures / adverse effects*
  • Humans
  • Intraoperative Period
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome
  • Wakefulness*