Cochrane CSEAvsEA4CS
.PDF
Analysis 1.12. Comparison 1 Combined spinal-epidural versus traditional epidural, Outcome 12 Hypotension.
Review: Combined spinal-epidural versus epidural analgesia in labour
Comparison: 1 Combined spinal-epidural versus traditional epidural
Outcome: 12 Hypotension
Study or subgroup |
CSE |
Epidural |
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Risk Ratio |
Risk Ratio |
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n/N |
n/N |
M-H,Fixed,95% CI |
M-H,Fixed,95% CI |
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1 Combined spinal-epidural versus traditional epidural |
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Gomez 2001 |
0/21 |
0/21 |
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0.0 [ 0.0, 0.0 ] |
Tsen 1999 |
0/50 |
0/50 |
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0.0 [ 0.0, 0.0 ] |
Subtotal (95% CI) |
71 |
71 |
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0.0 [ 0.0, 0.0 ] |
Total events: 0 (CSE), 0 (Epidural) |
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Heterogeneity: Chi2 = 0.0, df = 0 (P<0.00001); I2 =0.0% |
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Test for overall effect: Z = 0.0 (P < 0.00001) |
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2 Opioid combined spinal-epidural versus traditional epidural |
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Roux 1999 |
0/39 |
2/40 |
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0.21 [ 0.01, 4.14 ] |
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Subtotal (95% CI) |
39 |
40 |
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0.21 [ 0.01, 4.14 ] |
Total events: 0 (CSE), 2 (Epidural) |
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Heterogeneity: not applicable |
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Test for overall effect: Z = 1.03 (P = 0.30) |
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Total (95% CI) |
110 |
111 |
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0.21 [ 0.01, 4.14 ] |
Total events: 0 (CSE), 2 (Epidural) |
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Heterogeneity: Chi2 = 0.0, df = 0 (P = 1.00); I2 =0.0% |
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Test for overall effect: Z = 1.03 (P = 0.30) |
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0.01 |
0.1 |
1 |
10 |
100 |
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Favours CSE |
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Favours epidural |
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Combined spinal-epidural versus epidural analgesia in labour (Review) |
48 |
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. |
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Analysis 1.13. Comparison 1 Combined spinal-epidural versus traditional epidural, Outcome 13 Respiratory depression.
Review: Combined spinal-epidural versus epidural analgesia in labour
Comparison: 1 Combined spinal-epidural versus traditional epidural
Outcome: 13 Respiratory depression
Study or subgroup |
CSE |
Epidural |
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Risk Ratio |
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Risk Ratio |
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n/N |
n/N |
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M-H,Fixed,95% CI |
M-H,Fixed,95% CI |
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3 Opioid combined spinal-epidural versus traditional epidural |
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Caldwell 1994 |
0/26 |
0/33 |
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0.0 [ 0.0, 0.0 ] |
Roux 1999 |
0/39 |
0/40 |
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0.0 [ 0.0, 0.0 ] |
Total (95% CI) |
65 |
73 |
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0.0 [ 0.0, 0.0 ] |
Total events: 0 (CSE), 0 (Epidural) |
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Heterogeneity: Chi2 = 0.0, df = 0 (P<0.00001); I2 =0.0% |
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Test for overall effect: Z = 0.0 (P < 0.00001) |
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0.1 |
0.2 |
0.5 |
1 |
2 |
5 |
10 |
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Favours CSE |
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Favours epidural |
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Analysis 1.14. Comparison 1 Combined spinal-epidural versus traditional epidural, Outcome 14 Headache (any).
Review: Combined spinal-epidural versus epidural analgesia in labour
Comparison: 1 Combined spinal-epidural versus traditional epidural
Outcome: 14 Headache (any)
Study or subgroup |
Treatment |
Control |
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Risk Ratio |
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Weight |
Risk Ratio |
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n/N |
n/N |
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M-H,Fixed,95% CI |
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M-H,Fixed,95% CI |
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2 Opioid combined spinal-epidural versus traditional epidural |
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Roux 1999 |
1/39 |
1/40 |
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100.0 % |
1.03 [ 0.07, 15.83 ] |
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Total (95% CI) |
39 |
40 |
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100.0 % |
1.03 [ 0.07, 15.83 ] |
Total events: 1 (Treatment), 1 (Control) |
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Heterogeneity: not applicable |
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Test for overall effect: Z = 0.02 (P = 0.99) |
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0.01 |
0.1 |
1 |
10 |
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100 |
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Favours CSE |
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Favours epidural |
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Combined spinal-epidural versus epidural analgesia in labour (Review) |
49 |
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. |
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Analysis 1.15. Comparison 1 Combined spinal-epidural versus traditional epidural, Outcome 15 Sedation.
Review: Combined spinal-epidural versus epidural analgesia in labour
Comparison: 1 Combined spinal-epidural versus traditional epidural
Outcome: 15 Sedation
Study or subgroup |
Treatment |
Control |
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Risk Ratio |
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Weight |
Risk Ratio |
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n/N |
n/N |
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M-H,Fixed,95% CI |
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M-H,Fixed,95% CI |
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2 Opioid combined spinal-epidural versus traditional epidural |
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Roux 1999 |
9/39 |
9/40 |
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100.0 % |
1.03 [ 0.46, 2.31 ] |
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Total (95% CI) |
39 |
40 |
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100.0 % |
1.03 [ 0.46, 2.31 ] |
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Total events: 9 (Treatment), 9 (Control) |
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Heterogeneity: not applicable |
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Test for overall effect: Z = 0.06 (P = 0.95) |
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0.1 |
0.2 |
0.5 |
1 |
2 |
5 |
10 |
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Favours CSE |
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Favours epidural |
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Analysis 1.16. Comparison 1 Combined spinal-epidural versus traditional epidural, Outcome 16 Labour |
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augmentation required. |
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Review: Combined spinal-epidural versus epidural analgesia in labour |
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Comparison: 1 Combined spinal-epidural versus traditional epidural |
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Outcome: 16 Labour augmentation required |
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Study or subgroup |
CSE |
Epidural |
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Risk Ratio |
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Risk Ratio |
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n/N |
n/N |
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M-H,Fixed,95% CI |
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M-H,Fixed,95% CI |
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1 Combined spinal-epidural versus traditional epidural |
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COMET 2001a |
113/351 |
120/353 |
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0.95 [ 0.77, 1.17 ] |
Tsen 1999 |
40/50 |
43/50 |
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0.93 [ 0.78, 1.11 ] |
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Subtotal (95% CI) |
401 |
403 |
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0.94 [ 0.80, 1.11 ] |
Total events: 153 (CSE), 163 (Epidural) |
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Heterogeneity: Chi2 = 0.02, df = 1 (P = 0.88); I2 =0.0% |
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Test for overall effect: Z = 0.72 (P = 0.47) |
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2 Opioid combined spinal-epidural versus traditional epidural |
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Roux 1999 |
39/39 |
40/40 |
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0.0 [ 0.0, 0.0 ] |
Subtotal (95% CI) |
39 |
40 |
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0.0 [ 0.0, 0.0 ] |
Total events: 39 (CSE), 40 (Epidural) |
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0.1 |
0.2 |
0.5 |
1 |
2 |
5 |
10 |
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Favours CSE |
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Favours epidural |
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(Continued . . . ) |
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Combined spinal-epidural versus epidural analgesia in labour (Review) |
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50 |
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Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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(. . . Continued) |
Study or subgroup |
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CSE |
Epidural |
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Risk Ratio |
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Risk Ratio |
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n/N |
n/N |
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M-H,Fixed,95% CI |
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M-H,Fixed,95% CI |
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Heterogeneity: not applicable |
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Test for overall effect: Z = 0.0 (P < 0.00001) |
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Total (95% CI) |
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440 |
443 |
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0.94 [ 0.80, 1.11 ] |
Total events: 192 (CSE), 203 (Epidural) |
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Heterogeneity: Chi2 = 0.02, df = 1 (P = 0.88); I2 =0.0% |
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Test for overall effect: Z = 0.72 (P = 0.47) |
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0.1 |
0.2 |
0.5 |
1 |
2 |
5 |
10 |
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Favours CSE |
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Favours epidural |
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Analysis 1.17. Comparison 1 Combined spinal-epidural versus traditional epidural, Outcome 17 |
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Augmentation after analgesia. |
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Review: Combined spinal-epidural versus epidural analgesia in labour |
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Comparison: 1 Combined spinal-epidural versus traditional epidural |
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Outcome: 17 Augmentation after analgesia |
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Study or subgroup |
CSE |
Epidural |
Risk Ratio |
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Weight |
Risk Ratio |
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n/N |
n/N |
M-H,Fixed,95% CI |
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M-H,Fixed,95% CI |
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1 Combined spinal-epidural versus traditional epidural |
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Tsen 1999 |
8/50 |
16/50 |
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100.0 % |
0.50 [ 0.24, 1.06 ] |
Total (95% CI) |
50 |
50 |
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100.0 % |
0.50 [ 0.24, 1.06 ] |
Total events: 8 (CSE), 16 (Epidural) |
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Heterogeneity: not applicable |
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Test for overall effect: Z = 1.80 (P = 0.071) |
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0.1 |
0.2 |
0.5 |
1 |
2 |
5 |
10 |
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Favours CSE |
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Favours epidural |
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Combined spinal-epidural versus epidural analgesia in labour (Review) |
51 |
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Analysis 1.18. Comparison 1 Combined spinal-epidural versus traditional epidural, Outcome 18 Normal delivery.
Review: Combined spinal-epidural versus epidural analgesia in labour
Comparison: 1 Combined spinal-epidural versus traditional epidural
Outcome: 18 Normal delivery
Study or subgroup |
CSE |
Epidural |
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Risk Ratio |
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Weight |
Risk Ratio |
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n/N |
n/N |
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M-H,Fixed,95% CI |
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M-H,Fixed,95% CI |
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1 Combined spinal-epidural versus traditional epidural |
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COMET 2001a |
150/351 |
124/353 |
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55.8 % |
1.22 [ 1.01, 1.47 ] |
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Gomez 2001 |
11/21 |
12/21 |
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5.4 % |
0.92 [ 0.53, 1.59 ] |
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Tsen 1999 |
34/50 |
33/50 |
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14.9 % |
1.03 [ 0.78, 1.36 ] |
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Subtotal (95% CI) |
422 |
424 |
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76.1 % |
1.16 [ 0.99, 1.35 ] |
Total events: 195 (CSE), 169 (Epidural) |
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Heterogeneity: Chi2 = 1.66, df = 2 (P = 0.44); I2 =0.0% |
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Test for overall effect: Z = 1.89 (P = 0.059) |
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2 Opioid combined spinal-epidural versus traditional epidural |
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Caldwell 1994 |
14/26 |
23/33 |
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9.2 % |
0.77 [ 0.51, 1.18 ] |
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Roux 1999 |
29/39 |
33/40 |
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14.7 % |
0.90 [ 0.71, 1.14 ] |
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Subtotal (95% CI) |
65 |
73 |
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23.9 % |
0.85 [ 0.69, 1.05 ] |
Total events: 43 (CSE), 56 (Epidural) |
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Heterogeneity: Chi2 = 0.43, df = 1 (P = 0.51); I2 =0.0% |
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Test for overall effect: Z = 1.47 (P = 0.14) |
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Total (95% CI) |
487 |
497 |
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100.0 % |
1.09 [ 0.95, 1.23 ] |
Total events: 238 (CSE), 225 (Epidural) |
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Heterogeneity: Chi2 = 6.89, df = 4 (P = 0.14); I2 =42% |
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Test for overall effect: Z = 1.25 (P = 0.21) |
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0.1 |
0.2 |
0.5 |
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1 |
2 |
5 |
10 |
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Favours epidural |
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Favours CSE |
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Combined spinal-epidural versus epidural analgesia in labour (Review) |
52 |
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. |
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Analysis 1.19. Comparison 1 Combined spinal-epidural versus traditional epidural, Outcome 19 Instrumental delivery.
Review: Combined spinal-epidural versus epidural analgesia in labour
Comparison: 1 Combined spinal-epidural versus traditional epidural
Outcome: 19 Instrumental delivery
Study or subgroup |
CSE |
Epidural |
|
|
Risk Ratio |
|
Weight |
Risk Ratio |
|
|
n/N |
n/N |
|
M-H,Fixed,95% CI |
|
M-H,Fixed,95% CI |
|||
1 Combined spinal-epidural versus traditional epidural |
|
|
|
|
|
|
|
|
|
COMET 2001a |
102/351 |
131/353 |
|
|
|
|
|
86.8 % |
0.78 [ 0.63, 0.97 ] |
Gomez 2001 |
6/21 |
7/21 |
|
|
|
|
|
4.6 % |
0.86 [ 0.35, 2.12 ] |
Tsen 1999 |
8/50 |
8/50 |
|
|
|
|
|
5.3 % |
1.00 [ 0.41, 2.46 ] |
Subtotal (95% CI) |
422 |
424 |
|
|
|
|
|
96.7 % |
0.80 [ 0.65, 0.98 ] |
Total events: 116 (CSE), 146 (Epidural) |
|
|
|
|
|
|
|
|
|
Heterogeneity: Chi2 = 0.30, df = 2 (P = 0.86); I2 =0.0% |
|
|
|
|
|
|
|
|
|
Test for overall effect: Z = 2.19 (P = 0.029) |
|
|
|
|
|
|
|
|
|
2 Opioid combined spinal-epidural versus traditional epidural |
|
|
|
|
|
|
|
||
Roux 1999 |
7/39 |
5/40 |
|
|
|
|
|
3.3 % |
1.44 [ 0.50, 4.14 ] |
Subtotal (95% CI) |
39 |
40 |
|
|
|
|
|
3.3 % |
1.44 [ 0.50, 4.14 ] |
Total events: 7 (CSE), 5 (Epidural) |
|
|
|
|
|
|
|
|
|
Heterogeneity: not applicable |
|
|
|
|
|
|
|
|
|
Test for overall effect: Z = 0.67 (P = 0.50) |
|
|
|
|
|
|
|
|
|
Total (95% CI) |
461 |
464 |
|
|
|
|
|
100.0 % |
0.82 [ 0.67, 1.00 ] |
Total events: 123 (CSE), 151 (Epidural) |
|
|
|
|
|
|
|
|
|
Heterogeneity: Chi2 = 1.45, df = 3 (P = 0.69); I2 =0.0% |
|
|
|
|
|
|
|
|
|
Test for overall effect: Z = 1.97 (P = 0.049) |
|
|
|
|
|
|
|
|
|
|
|
0.1 |
0.2 |
0.5 |
1 |
2 |
5 |
10 |
|
|
|
|
Favours CSE |
|
Favours epidural |
|
|||
Combined spinal-epidural versus epidural analgesia in labour (Review) |
53 |
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Analysis 1.20. Comparison 1 Combined spinal-epidural versus traditional epidural, Outcome 20 Caesarean section.
Review: Combined spinal-epidural versus epidural analgesia in labour
Comparison: 1 Combined spinal-epidural versus traditional epidural
Outcome: 20 Caesarean section
Study or subgroup |
CSE |
Epidural |
|
|
Risk Ratio |
|
Weight |
Risk Ratio |
|
|
n/N |
n/N |
|
M-H,Fixed,95% CI |
|
M-H,Fixed,95% CI |
|||
1 Combined spinal-epidural versus traditional epidural |
|
|
|
|
|
|
|
|
|
COMET 2001a |
99/351 |
98/353 |
|
|
|
|
|
88.3 % |
1.02 [ 0.80, 1.29 ] |
Gomez 2001 |
4/21 |
2/21 |
|
|
|
|
|
1.8 % |
2.00 [ 0.41, 9.77 ] |
Tsen 1999 |
8/50 |
9/50 |
|
|
|
|
|
8.1 % |
0.89 [ 0.37, 2.12 ] |
Subtotal (95% CI) |
422 |
424 |
|
|
|
|
|
98.2 % |
1.02 [ 0.82, 1.28 ] |
Total events: 111 (CSE), 109 (Epidural) |
|
|
|
|
|
|
|
|
|
Heterogeneity: Chi2 = 0.79, df = 2 (P = 0.67); I2 =0.0% |
|
|
|
|
|
|
|
|
|
Test for overall effect: Z = 0.20 (P = 0.84) |
|
|
|
|
|
|
|
|
|
2 Opioid combined spinal-epidural versus traditional epidural |
|
|
|
|
|
|
|
||
Roux 1999 |
3/39 |
2/40 |
|
|
|
|
|
1.8 % |
1.54 [ 0.27, 8.71 ] |
Subtotal (95% CI) |
39 |
40 |
|
|
|
|
|
1.8 % |
1.54 [ 0.27, 8.71 ] |
Total events: 3 (CSE), 2 (Epidural) |
|
|
|
|
|
|
|
|
|
Heterogeneity: not applicable |
|
|
|
|
|
|
|
|
|
Test for overall effect: Z = 0.49 (P = 0.63) |
|
|
|
|
|
|
|
|
|
Total (95% CI) |
461 |
464 |
|
|
|
|
|
100.0 % |
1.03 [ 0.83, 1.29 ] |
Total events: 114 (CSE), 111 (Epidural) |
|
|
|
|
|
|
|
|
|
Heterogeneity: Chi2 = 1.00, df = 3 (P = 0.80); I2 =0.0% |
|
|
|
|
|
|
|
|
|
Test for overall effect: Z = 0.28 (P = 0.78) |
|
|
|
|
|
|
|
|
|
|
|
0.1 |
0.2 |
0.5 |
1 |
2 |
5 |
10 |
|
|
|
|
Favours CSE |
|
Favours epidural |
|
|||
Combined spinal-epidural versus epidural analgesia in labour (Review) |
54 |
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Analysis 1.21. Comparison 1 Combined spinal-epidural versus traditional epidural, Outcome 21 Umbilical arterial pH.
Review: Combined spinal-epidural versus epidural analgesia in labour
Comparison: 1 Combined spinal-epidural versus traditional epidural
Outcome: 21 Umbilical arterial pH
Study or subgroup |
CSE |
|
Epidural |
|
|
Mean Difference |
Weight |
Mean Difference |
||
|
N |
Mean(SD) |
N |
Mean(SD) |
IV,Fixed,95% CI |
|
IV,Fixed,95% CI |
|||
|
|
|
|
|
|
|
|
|||
2 Opioid combined spinal-epidural versus traditional epidural |
|
|
|
|
|
|
|
|||
Caldwell 1994 |
26 |
7.24 (0.1) |
29 |
7.26 (0.05) |
|
|
|
|
100.0 % |
-0.02 [ -0.06, 0.02 ] |
|
|
|
|
|||||||
Total (95% CI) |
26 |
|
29 |
|
|
|
|
|
100.0 % |
-0.02 [ -0.06, 0.02 ] |
Heterogeneity: not applicable |
|
|
|
|
|
|
|
|
|
|
Test for overall effect: Z = 0.92 (P = 0.36) |
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
-0.5 |
-0.25 |
0 |
0.25 |
0.5 |
|
|
|
|
|
|
Favours epidural |
Favours CSE |
|
||||
Analysis 1.22. Comparison 1 Combined spinal-epidural versus traditional epidural, Outcome 22 Umbilical |
||||||||||
|
|
|
|
venous pH. |
|
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|
Review: Combined spinal-epidural versus epidural analgesia in labour |
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|
||||
Comparison: 1 Combined spinal-epidural versus traditional epidural |
|
|
|
|
|
|
|
|||
Outcome: 22 Umbilical venous pH |
|
|
|
|
|
|
|
|
|
|
Study or subgroup |
CSE |
|
Epidural |
|
|
Mean Difference |
Weight |
Mean Difference |
||
|
N |
Mean(SD) |
N |
Mean(SD) |
IV,Fixed,95% CI |
|
IV,Fixed,95% CI |
|||
|
|
|
|
|
|
|
|
|||
2 Opioid combined spinal-epidural versus traditional epidural |
|
|
|
|
|
|
|
|||
Caldwell 1994 |
26 |
7.33 (0.05) |
29 |
7.36 (0.05) |
|
|
|
|
100.0 % |
-0.03 [ -0.06, 0.00 ] |
|
|
|
|
|||||||
Total (95% CI) |
26 |
|
29 |
|
|
|
|
|
100.0 % |
-0.03 [ -0.06, 0.00 ] |
Heterogeneity: not applicable |
|
|
|
|
|
|
|
|
|
|
Test for overall effect: Z = 2.22 (P = 0.026) |
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
-0.5 |
-0.25 |
0 |
0.25 |
0.5 |
|
|
|
|
|
|
Favours epidural |
Favours CSE |
|
||||
Combined spinal-epidural versus epidural analgesia in labour (Review) |
55 |
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. |
|
|
|
Analysis 1.24. Comparison 1 Combined spinal-epidural versus traditional epidural, Outcome 24 Apgar score < 7 at 5 minutes.
Review: Combined spinal-epidural versus epidural analgesia in labour
Comparison: 1 Combined spinal-epidural versus traditional epidural
Outcome: 24 Apgar score < 7 at 5 minutes
Study or subgroup |
CSE |
Epidural |
|
Risk Ratio |
Risk Ratio |
|
|
n/N |
n/N |
M-H,Fixed,95% CI |
M-H,Fixed,95% CI |
||
2 Opioid combined spinal-epidural versus traditional epidural |
|
|
|
|
|
|
Caldwell 1994 |
1/26 |
1/33 |
|
|
|
1.27 [ 0.08, 19.34 ] |
COMET 2001a |
7/351 |
3/353 |
|
|
|
2.35 [ 0.61, 9.00 ] |
Roux 1999 |
0/39 |
0/40 |
|
|
|
0.0 [ 0.0, 0.0 ] |
Total (95% CI) |
416 |
426 |
|
|
|
2.10 [ 0.63, 6.97 ] |
Total events: 8 (CSE), 4 (Epidural) |
|
|
|
|
|
|
Heterogeneity: Chi2 = 0.16, df = 1 (P = 0.69); I2 =0.0% |
|
|
|
|
|
|
Test for overall effect: Z = 1.21 (P = 0.22) |
|
|
|
|
|
|
|
|
0.01 |
0.1 |
1 |
10 |
100 |
|
|
Favours CSE |
|
Favours epidural |
||
Analysis 1.25. Comparison 1 Combined spinal-epidural versus traditional epidural, Outcome 25 Apgar score < 8 at 5 minutes.
Review: Combined spinal-epidural versus epidural analgesia in labour
Comparison: 1 Combined spinal-epidural versus traditional epidural
Outcome: 25 Apgar score < 8 at 5 minutes
Study or subgroup |
CSE |
Epidural |
|
Risk Ratio |
Weight |
Risk Ratio |
||
|
n/N |
n/N |
M-H,Fixed,95% CI |
|
M-H,Fixed,95% CI |
|||
|
|
|
|
|
|
|
||
1 Combined spinal-epidural versus traditional epidural |
|
|
|
|
|
|
||
COMET 2001a |
7/351 |
3/353 |
|
|
|
|
100.0 % |
2.35 [ 0.61, 9.00 ] |
|
|
|
|
|||||
|
|
|
|
|||||
Total (95% CI) |
351 |
353 |
|
|
|
|
100.0 % |
2.35 [ 0.61, 9.00 ] |
Total events: 7 (CSE), 3 (Epidural)
Heterogeneity: not applicable
Test for overall effect: Z = 1.24 (P = 0.21)
0.1 |
0.2 |
0.5 |
1 |
2 |
5 |
10 |
|
Favours CSE |
|
Favours epidural |
|||
Combined spinal-epidural versus epidural analgesia in labour (Review) |
56 |
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Analysis 1.26. Comparison 1 Combined spinal-epidural versus traditional epidural, Outcome 26 Number admitted to neonatal unit.
Review: Combined spinal-epidural versus epidural analgesia in labour
Comparison: 1 Combined spinal-epidural versus traditional epidural
Outcome: 26 Number admitted to neonatal unit
Study or subgroup |
CSE |
Epidural |
|
|
Risk Ratio |
Weight |
Risk Ratio |
|
|
n/N |
n/N |
M-H,Fixed,95% CI |
|
M-H,Fixed,95% CI |
|||
|
|
|
|
|
|
|
||
1 Combined spinal-epidural versus traditional epidural |
|
|
|
|
|
|
||
COMET 2001a |
10/351 |
16/353 |
|
|
|
|
100.0 % |
0.63 [ 0.29, 1.37 ] |
|
|
|
|
|||||
|
|
|
|
|||||
Total (95% CI) |
351 |
353 |
|
|
|
|
100.0 % |
0.63 [ 0.29, 1.37 ] |
Total events: 10 (CSE), 16 (Epidural)
Heterogeneity: not applicable
Test for overall effect: Z = 1.17 (P = 0.24)
0.1 |
0.2 |
0.5 |
1 |
2 |
5 |
10 |
|
Favours CSE |
|
Favours epidural |
|||
Analysis 2.1. Comparison 2 Combined spinal-epidural versus low-dose epidural, Outcome 1 Time from first |
||||||||||
|
|
|
injection to effective analgesia (minutes). |
|
|
|||||
Review: Combined spinal-epidural versus epidural analgesia in labour |
|
|
|
|
|
|
||||
Comparison: 2 Combined spinal-epidural versus low-dose epidural |
|
|
|
|
|
|
|
|||
Outcome: 1 Time from first injection to effective analgesia (minutes) |
|
|
|
|
|
|
||||
Study or subgroup |
CSE |
|
Epidural |
|
|
Mean Difference |
Weight |
Mean Difference |
||
|
N |
Mean(SD) |
N |
Mean(SD) |
IV,Fixed,95% CI |
|
IV,Fixed,95% CI |
|||
|
|
|
|
|
|
|
|
|||
1 Combined spinal-epidural versus low-dose epidural |
|
|
|
|
|
|
|
|||
Kartawiadi 1996 |
25 |
4 (2) |
25 |
10.4 (2.5) |
|
|
|
|
64.0 % |
-6.40 [ -7.65, -5.15 ] |
|
|
|
|
|||||||
Nickells 2000 |
61 |
10 (5.7) |
64 |
12.1 (6.5) |
|
|
|
|
22.0 % |
-2.10 [ -4.24, 0.04 ] |
|
|
|
|
|||||||
|
|
|
|
|||||||
Van de Velde 1999 |
55 |
5.43 (2.7) |
55 |
12.77 (9.76) |
|
|
|
|
14.1 % |
-7.34 [ -10.02, -4.66 ] |
Total (95% CI) |
141 |
|
144 |
|
|
|
|
|
100.0 % |
-5.59 [ -6.59, -4.58 ] |
Heterogeneity: Chi2 = 13.45, df = 2 (P = 0.001); I2 =85% |
|
|
|
|
|
|
|
|||
Test for overall effect: Z = 10.91 (P < 0.00001) |
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
-100 |
-50 |
0 |
50 |
100 |
|
|
|
|
|
|
Favours CSE |
Favours epidural |
|
||||
Combined spinal-epidural versus epidural analgesia in labour (Review) |
57 |
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. |
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