Analgesia combinada epidural-intradural para el trabajo de parto: Una revisión bibliográfica sistemática cuantitativa (metaanálisis)

Translated title of the contribution: Combined epidural-spinal analgesia during labor: A quantitative systematic review of the literature (meta-analysis)

Francisco Pascual-Ramirez, J. Haya Palazuelo, J. M. Valverde Mantecón

Research output: Contribution to journalArticle

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 contributionCombined epidural-spinal analgesia during labor: A quantitative systematic review of the literature (meta-analysis)
Original languageSpanish
Pages (from-to)489-497
Number of pages9
JournalRevista Espanola de Anestesiologia y Reanimacion
Volume60
Issue number9
DOIs
StatePublished - Nov 1 2013
Externally publishedYes

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

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