Abstract
Objective: To perform a meta-analysis on the use of combined epidural-intrathecal analgesia during labor, including intrathecal fentanyl and/or morphine compared to usual epidural techniques. Material and method: A literature search was made looking for randomized clinical trials in MEDLINE, EMBASE and Cochrane Library. The size of the effect for quantitative variables was analyzed by weighted mean difference; for qualitative variables, by odds ratio. Variables analyzed were: labor duration, type of delivery (spontaneous, instrumental and caesarean section), motor blockade, pain, and satisfaction. The analysis used in most cases was a random effects model. Results: A total of 21 trials, which included 3.646 patients, were selected out of the 38 initially found. The type of delivery variable with its 3 subgroups was the only one to show uniformity (p>Q 0.1; I2<50%). There were no differences in the variables analyzed except pain, which was advantageous for the group with intrathecal fentanyl or morphine by 0.55 points out of 10. Conclusion: Combined analgesia including intrathecal fentanyl-morphine does not offer significant advantages compared to the standard epidural.
Translated title of the contribution | Combined epidural-spinal analgesia during labor: A quantitative systematic review of the literature (meta-analysis) |
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Original language | Spanish |
Pages (from-to) | 489-497 |
Number of pages | 9 |
Journal | Revista Espanola de Anestesiologia y Reanimacion |
Volume | 60 |
Issue number | 9 |
DOIs | |
State | Published - Nov 2013 |
Externally published | Yes |
Keywords
- Combined analgesia
- Epidural analgesia
- Intrathecal opiates
- Labor analgesia
- Meta-analysis
- Neuraxial analgesia
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
- Anesthesiology and Pain Medicine