Cochrane · systematic review · CD000331
Epidural versus non‐epidural or no analgesia for pain management in labour
Anim‐Somuah, M, Smyth, RMD, Cyna, AM, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
7
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 4 · 57.1%Moderate 3 · 42.9%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Epidural compared to opioids in labour (maternal outcomes)
Population: women in labour
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity measured using pain score in labour (lower scores = less pain) Epidural vs opioids | no estimate extracted | 5 studies · 1133 participants | Low Downgraded: risk of bias, inconsistency |
Satisfaction with pain relief ‐ proportion rating excellent or very good Epidural vs opioids | RR 1.47 [1.03, 2.08] | 7 studies · 1911 participants | Low Downgraded: risk of bias, inconsistency |
Assisted vaginal birth Epidural vs opioids | RR 1.44 [1.29, 1.6] | 30 studies · 9948 participants | Low Downgraded: risk of bias, publication bias |
Caesarean section Epidural vs opioids | RR 1.07 [0.96, 1.18] | 33 studies · 10350 participants | Moderate Downgraded: risk of bias |
Side effects (maternal) ‐ long‐term backache Epidural vs opioids | RR 1 [0.89, 1.12] | 2 studies · 814 participants | Moderate Downgraded: risk of bias |
Admission to special care baby unit/neonatal intensive care unit (as defined by trialists) Epidural vs opioids | RR 1.03 [0.95, 1.12] | 8 studies · 4488 participants | Moderate Downgraded: risk of bias |
Apgar score less than 7 at 5 minutes Epidural vs opioids | RR 0.73 [0.52, 1.02] | 22 studies · 8752 participants | Low Downgraded: risk of bias, imprecision |