Scolaris Content Display Scolaris Content Display

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 1 Time from first injection to effective analgesia (minutes).
Figures and Tables -
Analysis 1.1

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 1 Time from first injection to effective analgesia (minutes).

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 2 Need for rescue analgesia.
Figures and Tables -
Analysis 1.2

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 2 Need for rescue analgesia.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 3 Number of women satisfied with analgesia.
Figures and Tables -
Analysis 1.3

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 3 Number of women satisfied with analgesia.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 4 Number of women who mobilise.
Figures and Tables -
Analysis 1.4

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 4 Number of women who mobilise.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 5 Post dural puncture headache.
Figures and Tables -
Analysis 1.5

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 5 Post dural puncture headache.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 6 Known dural tap.
Figures and Tables -
Analysis 1.6

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 6 Known dural tap.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 7 Number of women requiring blood patch for PDPH.
Figures and Tables -
Analysis 1.7

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 7 Number of women requiring blood patch for PDPH.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 8 Pruritus.
Figures and Tables -
Analysis 1.8

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 8 Pruritus.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 9 Urinary retention.
Figures and Tables -
Analysis 1.9

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 9 Urinary retention.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 10 Nausea/vomiting.
Figures and Tables -
Analysis 1.10

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 10 Nausea/vomiting.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 11 Hypotension.
Figures and Tables -
Analysis 1.11

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 11 Hypotension.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 12 Respiratory depression.
Figures and Tables -
Analysis 1.12

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 12 Respiratory depression.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 13 Headache (any).
Figures and Tables -
Analysis 1.13

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 13 Headache (any).

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 14 Sedation.
Figures and Tables -
Analysis 1.14

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 14 Sedation.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 15 Labour augmentation required.
Figures and Tables -
Analysis 1.15

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 15 Labour augmentation required.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 16 Augmentation after analgesia.
Figures and Tables -
Analysis 1.16

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 16 Augmentation after analgesia.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 17 Normal delivery.
Figures and Tables -
Analysis 1.17

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 17 Normal delivery.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 18 Instrumental delivery.
Figures and Tables -
Analysis 1.18

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 18 Instrumental delivery.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 19 Caesarean section.
Figures and Tables -
Analysis 1.19

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 19 Caesarean section.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 20 Umbilical arterial pH.
Figures and Tables -
Analysis 1.20

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 20 Umbilical arterial pH.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 21 Umbilical venous pH.
Figures and Tables -
Analysis 1.21

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 21 Umbilical venous pH.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 22 Umbilical cord pH.
Figures and Tables -
Analysis 1.22

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 22 Umbilical cord pH.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 23 Apgar score < 7 at 5 minutes.
Figures and Tables -
Analysis 1.23

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 23 Apgar score < 7 at 5 minutes.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 24 Apgar score < 8 at 5 minutes.
Figures and Tables -
Analysis 1.24

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 24 Apgar score < 8 at 5 minutes.

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 25 Number admitted to neonatal unit.
Figures and Tables -
Analysis 1.25

Comparison 1 Combined spinal epidural (CSE) versus (vs) epidural, Outcome 25 Number admitted to neonatal unit.

Table 1. Epidural techniques used ‐ initial dose and subsequent maintenance

Nil maintenance

Immediate infusion

Repeat boluses

Repeat boluses

Bolus/infusion

Repeat boluses

PCEA

LA + OPIOID

HIGH DOSE LA

LOW DOSE LA

LOW DOSE LA/OPIOID

LOW DOSE LA/OPIOID

INITIAL DOSE

Low‐dose bupivacaine < 0.25%

Abouliesh

Traditional dose bupivacaine = 0.25%

Tsen, Gomez

COMET

Low‐dose bupivacaine < 0.25% + opioid

Parry

COMET

Hepner

Kartawiadi, Nickells

Price, Van de Velde

Traditional dose bupivacaine + opioid

Caldwell

Roux

Test lignocaine + opioid

Dunn, Breen

Figures and Tables -
Table 1. Epidural techniques used ‐ initial dose and subsequent maintenance
Table 2. CSE techniques used ‐ initial IT injection and subsequent epidural

NIL EPIDURAL

IMMEDIATE INFUSION

IMMEDIATE BOLUS/INFUSION

IMMEDIATE BOLUS/BOLUSES

DELAY BOLUS/INFUSION

DELAYED BOLUSES

PCEA

IT INJECTION

IT opioid only

Breen, Dunn

Abouliesh, Roux

Caldwell

Abouliesh

IT LA + opioid

Parry

Gomez, Hepner, Tsen

COMET, Kartawiadi, Nickells

Price, Van de Velde

Figures and Tables -
Table 2. CSE techniques used ‐ initial IT injection and subsequent epidural
Comparison 1. Combined spinal epidural (CSE) versus (vs) epidural

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Time from first injection to effective analgesia (minutes) Show forest plot

4

364

Mean Difference (IV, Fixed, 95% CI)

‐5.50 [‐6.47, ‐4.52]

1.1 CSE vs traditional epidural

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 CSE vs low dose epidural

3

285

Mean Difference (IV, Fixed, 95% CI)

‐5.59 [‐6.59, ‐4.58]

1.3 Opioid CSE vs traditional epidural

1

79

Mean Difference (IV, Fixed, 95% CI)

‐4.0 [‐8.08, 0.08]

1.4 Opioid CSE vs test LA/opioid epidural

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Need for rescue analgesia Show forest plot

6

1097

Odds Ratio (M‐H, Fixed, 95% CI)

0.80 [0.60, 1.08]

2.1 CSE vs low dose epidural

4

986

Odds Ratio (M‐H, Fixed, 95% CI)

0.91 [0.67, 1.24]

2.2 CSE vs traditional epidural

1

42

Odds Ratio (M‐H, Fixed, 95% CI)

0.10 [0.02, 0.40]

2.3 Opioid CSE vs traditional epidural

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.4 Opioid CSE vs test LA/opioid epidural

1

69

Odds Ratio (M‐H, Fixed, 95% CI)

0.31 [0.01, 7.99]

2.5 Opioid CSE vs low dose epidural

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Number of women satisfied with analgesia Show forest plot

3

223

Odds Ratio (M‐H, Fixed, 95% CI)

4.69 [1.27, 17.29]

3.1 CSE vs traditional epidural

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.2 CSE vs low dose epidural

3

223

Odds Ratio (M‐H, Fixed, 95% CI)

4.69 [1.27, 17.29]

4 Number of women who mobilise Show forest plot

5

963

Odds Ratio (M‐H, Fixed, 95% CI)

1.07 [0.82, 1.39]

4.1 CSE vs low dose epidural

3

854

Odds Ratio (M‐H, Fixed, 95% CI)

0.99 [0.75, 1.32]

4.2 CSE vs traditional epidural

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.3 Opioid CSE vs test LA/opioid epidural

2

109

Odds Ratio (M‐H, Fixed, 95% CI)

1.99 [0.87, 4.59]

5 Post dural puncture headache Show forest plot

9

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 CSE vs low dose epidural

6

418

Odds Ratio (M‐H, Fixed, 95% CI)

2.46 [0.35, 17.29]

5.2 CSE vs traditional epidural

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 Opioid CSE vs traditional epidural

2

138

Odds Ratio (M‐H, Fixed, 95% CI)

3.94 [0.15, 100.81]

5.4 Opioid CSE vs test LA/opioid epidural

1

69

Odds Ratio (M‐H, Fixed, 95% CI)

0.31 [0.01, 7.99]

5.5 Opioid CSE vs low dose epidural

1

42

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.6 CSE vs epidural: overall

9

645

Odds Ratio (M‐H, Fixed, 95% CI)

1.46 [0.37, 5.71]

6 Known dural tap Show forest plot

6

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

6.1 CSE vs traditional epidural

1

704

Odds Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 8.23]

6.2 CSE vs low dose epidural

3

893

Odds Ratio (M‐H, Fixed, 95% CI)

0.14 [0.01, 2.74]

6.3 Opioid CSE vs traditional epidural

2

138

Odds Ratio (M‐H, Fixed, 95% CI)

7.18 [0.84, 61.72]

6.4 Opioid CSE vs test LA/opioid epidural

1

69

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.5 CSE vs epidural: overall

6

1453

Odds Ratio (M‐H, Fixed, 95% CI)

1.77 [0.53, 5.94]

7 Number of women requiring blood patch for PDPH Show forest plot

6

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

7.1 CSE vs low dose epidural

3

198

Odds Ratio (M‐H, Fixed, 95% CI)

5.16 [0.24, 112.01]

7.2 Opioid CSE vs low dose epidural

2

92

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.3 Opioid CSE vs test LA/opioid epidural

1

69

Odds Ratio (M‐H, Fixed, 95% CI)

0.31 [0.01, 7.99]

7.4 CSE vs traditional epidural

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.5 Opioid CSE vs traditional epidural

1

79

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.6 CSE vs epidural: overall

6

416

Odds Ratio (M‐H, Fixed, 95% CI)

1.47 [0.24, 8.98]

8 Pruritus Show forest plot

9

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

8.1 CSE vs low dose epidural

5

358

Odds Ratio (M‐H, Fixed, 95% CI)

1.87 [1.19, 2.94]

8.2 CSE vs traditional epidural

2

142

Odds Ratio (M‐H, Fixed, 95% CI)

10.45 [1.93, 56.64]

8.3 Opioid CSE vs traditional epidural

2

138

Odds Ratio (M‐H, Fixed, 95% CI)

22.15 [3.87, 126.79]

8.4 Opioid CSE vs low dose epidural

1

42

Odds Ratio (M‐H, Fixed, 95% CI)

9.0 [0.98, 83.06]

8.5 CSE vs epidural: overall

9

658

Odds Ratio (M‐H, Fixed, 95% CI)

2.79 [1.87, 4.18]

9 Urinary retention Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

9.1 CSE vs traditional epidural

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.2 CSE vs low dose epidural

2

126

Odds Ratio (M‐H, Fixed, 95% CI)

0.71 [0.29, 1.73]

9.3 Opioid CSE vs low dose epidural

1

34

Odds Ratio (M‐H, Fixed, 95% CI)

2.02 [0.51, 7.94]

9.4 CSE vs epidural: overall

2

142

Odds Ratio (M‐H, Fixed, 95% CI)

0.89 [0.39, 2.00]

10 Nausea/vomiting Show forest plot

8

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

10.1 CSE vs traditional epidural

2

142

Odds Ratio (M‐H, Fixed, 95% CI)

0.21 [0.02, 2.09]

10.2 CSE vs low dose epidural

3

202

Odds Ratio (M‐H, Fixed, 95% CI)

1.16 [0.54, 2.46]

10.3 Opioid CSE vs traditional epidural

2

138

Odds Ratio (M‐H, Fixed, 95% CI)

2.10 [1.03, 4.29]

10.4 Opioid CSE vs test LA/opioid epidural

1

69

Odds Ratio (M‐H, Fixed, 95% CI)

0.96 [0.30, 3.12]

10.5 Opioid CSE vs low dose epidural

1

42

Odds Ratio (M‐H, Fixed, 95% CI)

12.27 [0.62, 244.05]

10.6 CSE vs epidural: overall

8

571

Odds Ratio (M‐H, Fixed, 95% CI)

1.36 [0.87, 2.14]

11 Hypotension Show forest plot

10

791

Odds Ratio (M‐H, Fixed, 95% CI)

0.98 [0.39, 2.44]

11.1 CSE vs traditional epidural

2

142

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.2 CSE vs low dose epidural

6

501

Odds Ratio (M‐H, Fixed, 95% CI)

1.26 [0.46, 3.44]

11.3 Opioid CSE vs traditional epidural

1

79

Odds Ratio (M‐H, Fixed, 95% CI)

0.19 [0.01, 4.19]

11.4 Opioid CSE vs test LA/opioid epidural

1

69

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

12 Respiratory depression Show forest plot

5

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

12.1 CSE vs traditional epidural

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

12.2 CSE vs low dose epidural

2

92

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

12.3 Opioid CSE vs traditional epidural

2

138

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

12.4 Opioid CSE vs test LA/opioid epidural

1

69

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

12.5 Opioid CSE vs low dose epidural

1

42

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

13 Headache (any) Show forest plot

2

189

Odds Ratio (M‐H, Fixed, 95% CI)

0.33 [0.05, 2.11]

13.1 Opioid CSE vs traditional epidural

1

79

Odds Ratio (M‐H, Fixed, 95% CI)

1.03 [0.06, 17.01]

13.2 CSE vs low dose epidural

1

110

Odds Ratio (M‐H, Fixed, 95% CI)

0.14 [0.01, 2.68]

14 Sedation Show forest plot

1

79

Odds Ratio (M‐H, Fixed, 95% CI)

1.03 [0.36, 2.96]

14.1 Opioid CSE vs traditional epidural

1

79

Odds Ratio (M‐H, Fixed, 95% CI)

1.03 [0.36, 2.96]

14.2 CSE vs traditional epidural

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

15 Labour augmentation required Show forest plot

6

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

15.1 CSE vs traditional epidural

2

804

Odds Ratio (M‐H, Fixed, 95% CI)

0.90 [0.66, 1.21]

15.2 CSE vs low dose epidural

3

885

Odds Ratio (M‐H, Fixed, 95% CI)

0.89 [0.66, 1.20]

15.3 Opioid CSE vs traditional epidural

1

79

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

15.4 Opioid CSE vs test LA/opioid epidural

1

69

Odds Ratio (M‐H, Fixed, 95% CI)

1.72 [0.50, 5.90]

15.5 Opioid CSE vs low dose epidural

1

42

Odds Ratio (M‐H, Fixed, 95% CI)

0.53 [0.04, 6.29]

15.6 CSE vs epidural: overall

6

1506

Odds Ratio (M‐H, Fixed, 95% CI)

0.90 [0.70, 1.16]

16 Augmentation after analgesia Show forest plot

1

100

Odds Ratio (M‐H, Fixed, 95% CI)

0.40 [0.15, 1.06]

16.1 CSE vs traditional epidural

1

100

Odds Ratio (M‐H, Fixed, 95% CI)

0.40 [0.15, 1.06]

16.2 CSE vs low‐dose epidural

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

16.3 Opioid CSE vs traditional epidural

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

17 Normal delivery Show forest plot

12

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

17.1 CSE vs low dose epidural

7

1119

Odds Ratio (M‐H, Fixed, 95% CI)

0.96 [0.75, 1.23]

17.2 CSE vs traditional epidural

3

846

Odds Ratio (M‐H, Fixed, 95% CI)

1.31 [0.99, 1.73]

17.3 Opioid CSE vs traditional epidural

2

138

Odds Ratio (M‐H, Fixed, 95% CI)

0.56 [0.26, 1.20]

17.4 Opioid CSE vs test LA/opioid epidural

1

69

Odds Ratio (M‐H, Fixed, 95% CI)

0.86 [0.26, 2.87]

17.5 Opioid CSE vs low‐dose epidural

1

42

Odds Ratio (M‐H, Fixed, 95% CI)

0.89 [0.19, 4.15]

17.6 CSE vs epidural: overall

12

1841

Odds Ratio (M‐H, Fixed, 95% CI)

1.03 [0.84, 1.25]

18 Instrumental delivery Show forest plot

10

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

18.1 CSE vs low‐dose epidural

6

1059

Odds Ratio (M‐H, Fixed, 95% CI)

1.07 [0.80, 1.43]

18.2 CSE vs traditional epidural

3

846

Odds Ratio (M‐H, Fixed, 95% CI)

0.72 [0.54, 0.97]

18.3 Opioid CSE vs low‐dose epidural

1

42

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

18.4 Opioid CSE vs traditional epidural

1

79

Odds Ratio (M‐H, Fixed, 95% CI)

1.53 [0.44, 5.31]

18.5 Opioid CSE vs test LA/opioid epidural

1

69

Odds Ratio (M‐H, Fixed, 95% CI)

0.97 [0.13, 7.31]

18.6 CSE vs epidural: overall

10

1722

Odds Ratio (M‐H, Fixed, 95% CI)

0.91 [0.72, 1.15]

19 Caesarean section Show forest plot

10

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

19.1 CSE vs low‐dose epidural

6

1059

Odds Ratio (M‐H, Fixed, 95% CI)

0.98 [0.74, 1.31]

19.2 CSE vs traditional epidural

3

846

Odds Ratio (M‐H, Fixed, 95% CI)

1.03 [0.76, 1.41]

19.3 Opioid CSE vs traditional epidural

1

79

Odds Ratio (M‐H, Fixed, 95% CI)

1.58 [0.25, 10.03]

19.4 Opioid CSE vs test LA/opioid epidural

1

69

Odds Ratio (M‐H, Fixed, 95% CI)

1.25 [0.31, 5.11]

19.5 Opioid CSE vs low‐dose epidural

1

42

Odds Ratio (M‐H, Fixed, 95% CI)

1.13 [0.24, 5.25]

19.6 CSE vs epidural: overall

10

1722

Odds Ratio (M‐H, Fixed, 95% CI)

1.02 [0.81, 1.30]

20 Umbilical arterial pH Show forest plot

4

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

20.1 CSE versus traditional epidural

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.2 CSE versus low dose epidural

3

191

Mean Difference (IV, Fixed, 95% CI)

0.01 [‐0.02, 0.03]

20.3 Opioid CSE versus traditional epidural

1

55

Mean Difference (IV, Fixed, 95% CI)

‐0.02 [‐0.06, 0.02]

20.4 Opioid CSE versus low dose epidural

1

42

Mean Difference (IV, Fixed, 95% CI)

0.04 [‐0.03, 0.11]

20.5 CSE versus epidural: overall

4

266

Mean Difference (IV, Fixed, 95% CI)

‐0.00 [‐0.03, 0.02]

21 Umbilical venous pH Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

21.1 CSE versus traditional epidural

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

21.2 CSE versus low dose epidural

2

85

Mean Difference (IV, Fixed, 95% CI)

0.03 [‐0.00, 0.07]

21.3 Opioid CSE versus traditional epidural

1

55

Mean Difference (IV, Fixed, 95% CI)

‐0.03 [‐0.06, ‐0.00]

21.4 Opioid CSE versus low dose epidural

1

42

Mean Difference (IV, Fixed, 95% CI)

0.04 [‐0.00, 0.08]

21.5 CSE versus epidural: overall

3

160

Mean Difference (IV, Fixed, 95% CI)

‐0.01 [‐0.03, 0.02]

22 Umbilical cord pH Show forest plot

1

110

Mean Difference (IV, Fixed, 95% CI)

‐0.02 [‐0.05, 0.01]

22.1 CSE versus low dose epidural

1

110

Mean Difference (IV, Fixed, 95% CI)

‐0.02 [‐0.05, 0.01]

23 Apgar score < 7 at 5 minutes Show forest plot

5

391

Odds Ratio (M‐H, Fixed, 95% CI)

0.53 [0.10, 2.95]

23.1 CSE vs low‐dose epidural

3

253

Odds Ratio (M‐H, Fixed, 95% CI)

0.32 [0.03, 3.17]

23.2 CSE vs traditional epidural

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

23.3 Opioid CSE vs traditional epidural

2

138

Odds Ratio (M‐H, Fixed, 95% CI)

1.28 [0.08, 21.49]

24 Apgar score < 8 at 5 minutes Show forest plot

4

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

24.1 CSE vs traditional epidural

1

704

Odds Ratio (M‐H, Fixed, 95% CI)

2.37 [0.61, 9.26]

24.2 CSE vs low‐dose epidural

4

866

Odds Ratio (M‐H, Fixed, 95% CI)

0.80 [0.32, 2.00]

24.3 Opioid CSE vs low‐dose epidural

1

42

Odds Ratio (M‐H, Fixed, 95% CI)

3.46 [0.13, 89.95]

24.4 CSE vs epidural: overall

4

1239

Odds Ratio (M‐H, Fixed, 95% CI)

1.22 [0.52, 2.83]

25 Number admitted to neonatal unit Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

25.1 CSE vs traditional epidural

1

704

Odds Ratio (M‐H, Fixed, 95% CI)

0.62 [0.28, 1.38]

25.2 CSE vs low‐dose epidural

2

751

Odds Ratio (M‐H, Fixed, 95% CI)

0.76 [0.33, 1.76]

25.3 CSE vs epidural: overall

2

1104

Odds Ratio (M‐H, Fixed, 95% CI)

0.68 [0.33, 1.41]

Figures and Tables -
Comparison 1. Combined spinal epidural (CSE) versus (vs) epidural