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Migraine Headaches after Major Surgery with General or Neuraxial Anesthesia: A Nationwide Propensity-Score Matched Study

Author

Listed:
  • Chung-Yi Liao

    (Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
    Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan)

  • Chun-Cheng Li

    (Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
    Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan)

  • Hsin-Yi Liu

    (Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
    Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan)

  • Jui-Tai Chen

    (Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
    Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan)

  • Yih-Giun Cherng

    (Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
    Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan)

  • Tzeng-Ji Chen

    (Department of Family Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
    School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan)

  • Ying-Xiu Dai

    (School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
    Department of Dermatology, Taipei Veterans General Hospital, Taipei 11217, Taiwan)

  • Hsiang-Ling Wu

    (School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
    Department of Anesthesiology, Taipei Veterans General Hospital, Taipei 11217, Taiwan)

  • Wan-Chi Liu

    (Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
    Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan)

  • Ying-Hsuan Tai

    (Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
    Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan)

Abstract

Migraine headaches can be provoked by surgical stress and vasoactive effects of anesthetics of general anesthesia in the perioperative period. However, it is unclear whether general anesthesia increases the migraine risk after major surgery. Incidence and risk factors of postoperative migraine are also largely unknown. We utilized reimbursement claims data of Taiwan’s National Health Insurance and performed propensity score matching analyses to compare the risk of postoperative migraine in patients without migraine initially who underwent general or neuraxial anesthesia. Multivariable logistic regressions were applied to calculate the adjusted odds ratio (aOR) and 95% confidence interval (CI) for migraine risk. A total of 68,131 matched pairs were analyzed. The overall incidence of migraine was 9.82 per 1000 person-years. General anesthesia was not associated with a greater risk of migraine compared with neuraxial anesthesia (aORs: 0.93, 95% CI: 0.80–1.09). This finding was consistent across subgroups of different migraine subtypes, uses of migraine medications, and varying postoperative periods. Influential factors for postoperative migraine were age (aOR: 0.99), sex (male vs. female, aOR: 0.50), pre-existing anxiety disorder (aOR: 2.43) or depressive disorder (aOR: 2.29), concurrent uses of systemic corticosteroids (aOR: 1.45), ephedrine (aOR: 1.45), and theophylline (aOR: 1.40), and number of emergency room visits before surgery. There was no difference in the risk of postoperative migraine between surgical patients undergoing general and neuraxial anesthesia. This study identified the risk factors for postoperative migraine headaches, which may provide an implication in facilitating early diagnoses and treatment.

Suggested Citation

  • Chung-Yi Liao & Chun-Cheng Li & Hsin-Yi Liu & Jui-Tai Chen & Yih-Giun Cherng & Tzeng-Ji Chen & Ying-Xiu Dai & Hsiang-Ling Wu & Wan-Chi Liu & Ying-Hsuan Tai, 2021. "Migraine Headaches after Major Surgery with General or Neuraxial Anesthesia: A Nationwide Propensity-Score Matched Study," IJERPH, MDPI, vol. 19(1), pages 1-12, December.
  • Handle: RePEc:gam:jijerp:v:19:y:2021:i:1:p:362-:d:714258
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    References listed on IDEAS

    as
    1. Yu-Ming Wu & Hsien-Cheng Kuo & Chun-Cheng Li & Hsiang-Ling Wu & Jui-Tai Chen & Yih-Giun Cherng & Tzeng-Ji Chen & Ying-Xiu Dai & Hsin-Yi Liu & Ying-Hsuan Tai, 2020. "Preexisting Dementia Is Associated with Increased Risks of Mortality and Morbidity Following Major Surgery: A Nationwide Propensity Score Matching Study," IJERPH, MDPI, vol. 17(22), pages 1-12, November.
    2. Yu-Hsiang Chung & Hsien-Cheng Kuo & Hsin-Yi Liu & Mei-Yi Wu & Wei-Jen Chang & Jui-Tai Chen & Yih-Giun Cherng & Tzeng-Ji Chen & Ying-Xiu Dai & Hsiang-Ling Wu & Wan-Chi Liu & Ying-Hsuan Tai, 2021. "Association between Dental Scaling and Reduced Risk of End-Stage Renal Disease: A Nationwide Matched Cohort Study," IJERPH, MDPI, vol. 18(17), pages 1-13, August.
    Full references (including those not matched with items on IDEAS)

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