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Volume 19
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Article

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

by
Chung-Yi Liao
1,2,
Chun-Cheng Li
1,2,
Hsin-Yi Liu
1,2,
Jui-Tai Chen
1,2,
Yih-Giun Cherng
1,2,
Tzeng-Ji Chen
3,4,
Ying-Xiu Dai
4,5,
Hsiang-Ling Wu
4,6,
Wan-Chi Liu
1,2,* and
Ying-Hsuan Tai
1,2,*
1
Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
2
Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
3
Department of Family Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
4
School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
5
Department of Dermatology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
6
Department of Anesthesiology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
*
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2022, 19(1), 362; https://doi.org/10.3390/ijerph19010362
Submission received: 16 November 2021 / Revised: 22 December 2021 / Accepted: 28 December 2021 / Published: 30 December 2021
(This article belongs to the Section Public Health Statistics and Risk Assessment)
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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.
Keywords: headache; postoperative; risk factor; spinal anesthesia; stress headache; postoperative; risk factor; spinal anesthesia; stress

Share and Cite

MDPI and ACS Style

Liao, C.-Y.; Li, C.-C.; Liu, H.-Y.; Chen, J.-T.; Cherng, Y.-G.; Chen, T.-J.; Dai, Y.-X.; Wu, H.-L.; Liu, W.-C.; Tai, Y.-H. Migraine Headaches after Major Surgery with General or Neuraxial Anesthesia: A Nationwide Propensity-Score Matched Study. Int. J. Environ. Res. Public Health 2022, 19, 362. https://doi.org/10.3390/ijerph19010362

AMA Style

Liao C-Y, Li C-C, Liu H-Y, Chen J-T, Cherng Y-G, Chen T-J, Dai Y-X, Wu H-L, Liu W-C, Tai Y-H. Migraine Headaches after Major Surgery with General or Neuraxial Anesthesia: A Nationwide Propensity-Score Matched Study. International Journal of Environmental Research and Public Health. 2022; 19(1):362. https://doi.org/10.3390/ijerph19010362

Chicago/Turabian Style

Liao, Chung-Yi, Chun-Cheng Li, Hsin-Yi Liu, Jui-Tai Chen, Yih-Giun Cherng, Tzeng-Ji Chen, Ying-Xiu Dai, Hsiang-Ling Wu, Wan-Chi Liu, and Ying-Hsuan Tai. 2022. "Migraine Headaches after Major Surgery with General or Neuraxial Anesthesia: A Nationwide Propensity-Score Matched Study" International Journal of Environmental Research and Public Health 19, no. 1: 362. https://doi.org/10.3390/ijerph19010362

APA Style

Liao, C.-Y., Li, C.-C., Liu, H.-Y., Chen, J.-T., Cherng, Y.-G., Chen, T.-J., Dai, Y.-X., Wu, H.-L., Liu, W.-C., & Tai, Y.-H. (2022). Migraine Headaches after Major Surgery with General or Neuraxial Anesthesia: A Nationwide Propensity-Score Matched Study. International Journal of Environmental Research and Public Health, 19(1), 362. https://doi.org/10.3390/ijerph19010362

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