The effect of early epidural block administration on the progression and outcome of labor

Luxman, Dov; Wolman, Igal; Groutz, Asnat; Cohen, Jerome; Lottan, M; Pauzner, David; Moher, David

doi:10.1016/s0959-289x(98)80004-6

Cited by 45 publications

(38 citation statements)

References 14 publications

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“…In the RCT of Luxman et al 16 an inappropriate method of randomisation was used because participants were divided according to their sequence of arrival into two groups.…”

Section: Methodological Quality and Statistical Heterogeneitymentioning

confidence: 99%

“…The RCTs of Luxman and Ohel did not report the rate of withdrawals, cross-over or dropouts. 16,17 No statistical heterogeneity among the selected studies was detected for the overall rate of caesarean delivery (I 2 = 0.0%, 95% CI 0.0-89.2), caesarean delivery for dystocia (I 2 = 0.0%, 95% CI 0.0-88.7), caesarean delivery for other fetal status (I 2 = 35.3%, 95% CI 0.0-96.0), spontaneous vaginal delivery (I 2 = 0.0%, 95% CI )0.0-95.8). However, confidence intervals around the I 2 estimates were wide because of the low number of studies included.…”

Section: Methodological Quality and Statistical Heterogeneitymentioning

confidence: 99%

“…Of the selected studies, five concerned nulliparous women only. 7,[16][17][18][19] The retrospective cohort study of Ohel and Harats 20 presented results for both nulliparous and multiparous women. Only nulliparity-related results were included in this review, however.…”

Section: Description Of Studies and Characteristicsmentioning

confidence: 99%

“…Continuous EA was achieved by using bupivacaine 0.25%, 8 ml/hour. 16 Wong et al 7,18 randomised women after the first request for analgesia to receive intrathecal fentanyl or systemic hydromorphone. Subsequently patient-controlled epidural analgesia was initiated in the intrathecal group at the second request and in the systemic group at a cervical dilatation of at least 4 cm or at the third request for analgesia.…”

Section: Description Of Studies and Characteristicsmentioning

confidence: 99%

See 3 more Smart Citations

Early versus late epidural analgesia and risk on instrumental delivery in nulliparous women: a systematic review

Wassen

Zuijlen

Roumen

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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Background The optimal timing of epidural analgesia during labour and delivery has been a controversial issue.Objective Review of the literature regarding the relation between the timing of epidural analgesia and the rate of caesarean or instrumental vaginal deliveries.Search strategy Pubmed, Embase and the Cochrane Library were searched for articles published until 31 July 2010.Selection criteria Studies were selected in which the effects of early latent phase (defined as a cervical dilatation of 3 cm or less) epidural analgesia (including combined-spinal epidural) and late active phase epidural analgesia on the mode of delivery in nulliparous women at 36 weeks of gestation or more were evaluated.Data collection and analysis Data extraction was completed by using a data-extraction form. Risk ratio and its 95% confidence intervals were calculated for caesarean delivery and instrumental vaginal delivery. Pooled data were calculated.Main results The search retrieved 20 relevant articles, of which six fulfilled the selection criteria of inclusion. These six studies reported on 15 399 nulliparous women in spontaneous or induced labour with a request for analgesia. Risk of caesarean delivery (pooled risk ratio 1.02, 95% CI 0.96-1.08) or instrumental vaginal delivery (pooled risk ratio 0.96, 95% CI 0.89-1.05) was not significantly different between groups.Authors' conclusions This systematic review showed no increased risk of caesarean delivery or instrumental vaginal delivery for women receiving early epidural analgesia at cervical dilatation of 3 cm or less in comparison with late epidural analgesia.

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“…In the RCT of Luxman et al 16 an inappropriate method of randomisation was used because participants were divided according to their sequence of arrival into two groups.…”

Section: Methodological Quality and Statistical Heterogeneitymentioning

confidence: 99%

Section: Methodological Quality and Statistical Heterogeneitymentioning

confidence: 99%

Section: Description Of Studies and Characteristicsmentioning

confidence: 99%

Section: Description Of Studies and Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Early versus late epidural analgesia and risk on instrumental delivery in nulliparous women: a systematic review

Wassen

Zuijlen

Roumen

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

View full text Add to dashboard Cite

show abstract

“…Metaanalysen randomisiert-kontrollierter Studien zeigen unklare Ergebnisse für spontane, instrumentelle Entbindungen und Sectiones beim Vergleich von früh-zeitiger (Muttermund < 4-5 cm) und später (Muttermund > 4-5 cm) Anlage einer PDA [36][37][38][39][40]. Auch eine Studie, die sich mit dem Vergleich von früher und spä- [85][86][87][88][89][90].…”

Section: Optimaler Zeitpunkt Des Neuroaxialen Verfahrensunclassified