Literature Reviews
Procedure-specific systematic review summary
Bibliography
C-Section 2014
Najafi Anaraki and Mirzaei 2014
The effect of gabapentin versus intrathecal fentanyl on postoperative pain and morphine consumption in cesarean delivery: a prospective, randomized, double-blind study.
Najafi Anaraki A, Mirzaei K.
Arch Gynecol Obstet. 2014 Jul;290(1):47-52
http://www.ncbi.nlm.nih.gov/pubmed/24518937
Moore et al 2011
Gabapentin improves postcesarean delivery pain management: a randomized, placebo-controlled trial.
Moore A, Costello J, Wieczorek P, Shah V, Taddio A, Carvalho JC.
Anesth Analg. 2011 Jan;112(1):167-73
http://www.ncbi.nlm.nih.gov/pubmed/21081764
Short et al 2012
A single preoperative dose of gabapentin does not improve postcesarean delivery pain management: a randomized, double-blind, placebo-controlled dose-finding trial.
Short J, Downey K, Bernstein P, Shah V, Carvalho JC.
Anesth Analg. 2012 Dec;115(6):1336-42
http://www.ncbi.nlm.nih.gov/pubmed/23011560
Cardoso et al 2013
Effect of dexamethasone on prevention of postoperative nausea, vomiting and pain after caesarean section: a randomised, placebo-controlled, double-blind trial.
Cardoso MM, Leite AO, Santos EA, Gozzani JL, Mathias LA.
Eur J Anaesthesiol 2013;30(3):102-105
http://www.ncbi.nlm.nih.gov/pubmed/23022704
Wu et al 2007
Prevention of postoperative nausea and vomiting after intrathecal morphine for Cesarean section: a randomized comparison of dexamethasone, droperidol, and a combination.
Wu JI, Lo Y, Chia YY, Liu K, Fong WP, Yang LC, Tan PH.
Int J Obstet Anesth. 2007 Apr;16(2):122-7.
http://www.ncbi.nlm.nih.gov/pubmed/17275282
Davies et al 1997
Maternal experience during epidural or combined spinal-epidural anesthesia for cesarean section: a prospective, randomized trial.
Davies SJ, Paech MJ, Welch H, Evans SF, Pavy TJ
Anesth Analg. 1997 Sep;85(3):607-13.
http://www.ncbi.nlm.nih.gov/pubmed/9296417
Lew et al 2004
Combined spinal-epidural anesthesia using epidural volume extension leads to faster motor recovery after elective cesarean delivery: a prospective, randomized, double-blind study.
Lew E, Yeo SW, Thomas E.
Anesth Analg 2004;98(3):810–814.
Epidural volume extension (EVE) via a combined spinal-epidural (CSE) technique is the enhancement of a small-dose intrathecal block by epidural saline boluses. In this prospective, randomized, double-blind study, we compared the EVE technique with single-shot spinal anesthesia with respect to its sensory and motor block profile and hemodynamic stability. Sixty-two parturients (n = 31 in each group) undergoing elective cesarean deliveries were administered either spinal anesthesia with hyperbaric 0.5% bupivacaine 9 mg and fentanyl 10 microg or CSE comprising intrathecal hyperbaric 0.5% bupivacaine 5 mg with fentanyl 10 microg, followed by 0.9% saline 6.0 mL through the epidural catheter 5 min thereafter. In each group, the lowest systolic blood pressure (SBP), sensory block level to loss of pain from pinprick, and modified Bromage scores were recorded at 2.5-min intervals. The visual analog pain score (VAS), peak sensory block height, highest modified Bromage motor score, time for sensory regression to the tenth thoracic dermatome (T10), and motor block recovery were compared between groups. Both groups were comparable in demographic data, VAS scores, peak sensory block height, time for sensory regression to T10, and lowest SBP recorded. Patients in the EVE group demonstrated significantly faster motor recovery to modified Bromage 0 (73 +/- 33 min versus 136 +/- 32 min, P < 0.05). IMPLICATIONS: When compared with conventional, single-shot spinal anesthesia, epidural volume extension of a small-dose spinal block provides satisfactory anesthesia for cesarean delivery with only 55% of the bupivacaine dose required and is associated with faster motor recovery of the lower limbs.
Thorén et al 1994
Sequential combined spinal epidural block versus spinal block for cesarean section: effects on maternal hypotension and neurobehavioral function of the newborn.
Thorén T, Holmström B, Rawal N, Schollin J, Lindeberg S, Skeppner G.
Anesth Analg. 1994 Jun;78(6):1087-92.
http://www.ncbi.nlm.nih.gov/pubmed/8198262
Ng et al 2004
Spinal versus epidural anaesthesia for caesarean section.
Ng K, Parsons J, Cyna A, Middleton P.
Cochrane Database Syst Rev 2004;2:CD003765.
BACKGROUND: Regional anaesthesia (spinal or epidural anaesthesia) for caesarean section is the preferred option when balancing risks and benefits to the mother and her fetus. Spinal anaesthesia for caesarean section is thought to be advantageous due to simplicity of technique, rapid administration and onset of anaesthesia, reduced risk of systemic toxicity and increased density of spinal anaesthetic block. OBJECTIVES: To assess the relative efficacy and side-effects of spinal versus epidural anaesthesia in women having caesarean section. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group Trials Register (February 2003) and the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2003). SELECTION CRITERIA: Types of studies considered for review include all published randomised controlled trials involving a comparison of spinal with epidural anaesthesia for caesarean section. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trials for inclusion. Review Manager software was used for calculation of the treatment effect represented by relative risk (RR) and weighted mean difference (WMD) using a random effects model with 95% confidence intervals (CI). MAIN RESULTS: Ten trials (751 women) met our inclusion criteria. No difference was found between spinal and epidural techniques with regards to failure rate (RR 0.98, 95% CI 0.23 to 4.24; four studies), need for additional intraoperative analgesia (RR 0.88, 95% CI 0.59 to 1.32; five studies), need for conversion to general anaesthesia intraoperatively, maternal satisfaction, need for postoperative pain relief and neonatal intervention. Women receiving spinal anaesthesia for caesarean section showed reduced time from start of the anaesthetic to start of the operation (WMD 7.91 minutes less (95% CI -11.59 to -4.23; four studies), but increased need for treatment of hypotension RR 1.23 (95% CI 1.00 to 1.51; six studies). REVIEWERS' CONCLUSIONS: Both spinal and epidural techniques are shown to provide effective anaesthesia for caesarean section. Both techniques are associated with moderate degrees of maternal satisfaction. Spinal anaesthesia has a shorter onset time, but treatment for hypotension is more likely if spinal anaesthesia is used. No conclusions can be drawn about intraoperative side-effects and postoperative complications because they were of low incidence and/or not reported.
Paraskeva et al 2012
Postoperative analgesic requirements after subarachnoid or epidural anesthesia with ropivacaine 0.75% in cesarean section. A double-blind randomized trial.
Paraskeva A, Diamantis M, Petropoulos G, Siafaka I, Fassoulaki A.
Curr Med Res Opin. 2012 Sep;28(9):1497-504.
http://www.ncbi.nlm.nih.gov/pubmed/22937725
Afolabi and Lesi 2012
Regional versus general anaesthesia for caesarean section
Afolabi BB, Lesi FE.
Cochrane Database of Systematic Reviews, 2012. DOI: 10.1002/14651858.CD004350.pub3.
http://www.ncbi.nlm.nih.gov/pubmed/23076903
McDonnell et al 2010
A randomised comparison of regular oral oxycodone and intrathecal morphine for post-caesarean analgesia.
McDonnell NJ, Paech MJ, Browning RM, Nathan EA.
Int J Obstet Anesth. 2010 Jan;19(1):16-23
http://www.ncbi.nlm.nih.gov/pubmed/19700304
Abouleish et al 1988
Combined intrathecal morphine and bupivacaine for cesarean section
Abouleish E, Rawal N, Fallon K, Hernandez D.
Anesth Analg 1988;67(4):370-374.
http://www.ncbi.nlm.nih.gov/pubmed/3354872
Girgin et al 2008
Intrathecal morphine in anesthesia for cesarean delivery: dose-response relationship for combinations of low-dose intrathecal morphine and spinal bupivacaine.
Girgin NK, Gurbet A, Turker G, Aksu H, Gulhan N.
J Clin Anesth. 2008 May;20(3):180-5
http://www.ncbi.nlm.nih.gov/pubmed/18502360
Mikuni et al 2010
Efficacy of intrathecal morphine with epidural ropivacaine infusion for postcesarean analgesia.
Mikuni I, Hirai H, Toyama Y, Takahata O, Iwasaki H.
J Clin Anesth. 2010 Jun;22(4):268-73
http://www.ncbi.nlm.nih.gov/pubmed/20522357
Swart et al 1997
Intrathecal morphine for caesarean section: an assessment of pain relief, satisfaction and side-effects.
Swart M, Sewell J, Thomas D.
Anaesthesia. 1997 Apr;52(4):373-7.
http://www.ncbi.nlm.nih.gov/pubmed/9135193
Terajima et al 2003
Efficacy of intrathecal morphine for analgesia following elective cesarean section: comparison with previous delivery.
Terajima K, Onodera H, Kobayashi M, Yamanaka H, Ohno T, Konuma S, Ogawa R.
J Nippon Med Sch. 2003 Aug;70(4):327-33.
http://www.ncbi.nlm.nih.gov/pubmed/12928713
Abboud et al 1988
Mini-dose intrathecal morphine for the relief of post-cesarean section pain: safety, efficacy, and ventilatory responses to carbon dioxide
Abboud TK, Dror A, Mosaad P, Zhu J, Mantilla M, Swart F, Gangolly J, Silao P, Makar A, Moore J, et al.
Anesth Analg 1988;67(2):137-143
http://www.ncbi.nlm.nih.gov/pubmed/3277478
Draisci et al 2009
Safety and effectiveness of coadministration of intrathecal sufentanil and morphine in hyperbaric bupivacaine-based spinal anesthesia for cesarean section.
Draisci G, Frassanito L, Pinto R, Zanfini B, Ferrandina G, Valente A.
J Opioid Manag. 2009 Jul-Aug;5(4):197-202.
http://www.ncbi.nlm.nih.gov/pubmed/19736899
Unlugenc et al 2012
A comparative study on the effects of intrathecal morphine added to levobupivacaine for spinal anesthesia.
Unlugenc H, Gunduz M, Guzel B, Isik G.
J Opioid Manag. 2012 Mar-Apr;8(2):105-13.
http://www.ncbi.nlm.nih.gov/pubmed/22616316
Caranza et al 1999
Central neuraxial opioid analgesia after caesarean section: comparison of epidural diamorphine and intrathecal morphine.
Caranza R, Jeyapalan I, Buggy DJ.
Int J Obstet Anesth 1999;8(2):90-93.
http://www.ncbi.nlm.nih.gov/pubmed/15321151
Paech et al 2000
Postoperative intraspinal opioid analgesia after caesarean section; a randomised comparison of subarachnoid morphine and epidural pethidine.
Paech MJ, Pavy TJ, Orlikowski CE, Kuh J, Yeo ST, Lim K, Evans SF.
Int J Obstet Anesth. 2000 Oct;9(4):238-45.
http://www.ncbi.nlm.nih.gov/pubmed/15321077
Dualé et al 2003
Epidural versus intrathecal morphine for postoperative analgesia after Caesarean section.
Dualé C, Frey C, Bolandard F, Barrière A, Schoeffler P.
Br J Anaesth. 2003 Nov;91(5):690-4.
http://www.ncbi.nlm.nih.gov/pubmed/14570792
Sarvela et al 2002
A double-blinded, randomized comparison of intrathecal and epidural morphine for elective cesarean delivery.
Sarvela J, Halonen P, Soikkeli A, Korttila K
Anesth Analg. 2002 Aug;95(2):436-40
http://www.ncbi.nlm.nih.gov/pubmed/12145067
Chung et al 1998
The efficacy of intrathecal neostigmine, intrathecal morphine, and their combination for post-cesarean section analgesia.
Chung CJ, Kim JS, Park HS, Chin YJ.
Anesth Analg. 1998 Aug;87(2):341-6.
http://www.ncbi.nlm.nih.gov/pubmed/9706928
Culebras et al 2000
Advantages of intrathecal nalbuphine, compared with intrathecal morphine, after cesarean delivery: an evaluation of postoperative analgesia and adverse effects.
Culebras X, Gaggero G, Zatloukal J, Kern C, Marti RA.
Anesth Analg. 2000 Sep;91(3):601-5.
http://www.ncbi.nlm.nih.gov/pubmed/10960384
Siti Salmah and Choy 2009
Comparison of morphine with fentanyl added to intrathecal 0.5% hyperbaric bupivacaine for analgesia after caesarean section.
Siti Salmah G, Choy YC.
Med J Malaysia. 2009 Mar;64(1):71-4.
http://www.ncbi.nlm.nih.gov/pubmed/19852327
Barkshire et al 2001
A comparison of bupivacaine-fentanyl-morphine with bupivacaine-fentanyl-diamorphine for caesarean section under spinal anaesthesia.
Barkshire K, Russell R, Burry J, Popat M.
Int J Obstet Anesth 2001;10(1):4-10.
http://www.ncbi.nlm.nih.gov/pubmed/15321645
Milner et al 1996
Intrathecal administration of morphine for elective Caesarean section. A comparison between 0.1 mg and 0.2 mg.
Milner AR, Bogod DG, Harwood RJ.
Anaesthesia. 1996 Sep;51(9):871-3.
http://www.ncbi.nlm.nih.gov/pubmed/8882255
Carvalho et al 2012
Intrathecal fentanyl added to bupivacaine and morphine for cesarean delivery may induce a subtle acute opioid tolerance.
Carvalho B, Drover DR, Ginosar Y, Cohen SE, Riley ET.
Int J Obstet Anesth. 2012 Jan;21(1):29-34
http://www.ncbi.nlm.nih.gov/pubmed/22100823
Cardoso et al 1998
Small doses of intrathecal morphine combined with systemic diclofenac for postoperative pain control after cesarean delivery.
Cardoso MM, Carvalho JC, Amaro AR, Prado AA, Cappelli EL.
Anesth Analg 1998;86(3):538-541.
http://www.ncbi.nlm.nih.gov/pubmed/9495409
Choi et al 2003
Dextromethorphan and intrathecal morphine for analgesia after Caesarean section under spinal anaesthesia.
Choi DM, Kliffer AP, Douglas MJ.
Br J Anaesth. 2003 May;90(5):653-8.
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Cohen et al 1996
Ketorolac and spinal morphine for postcesarean analgesia.
Cohen SE, Desai JB, Ratner EF, Riley ET, Halpern J.
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Evaluation of the analgesic effect of ketamine as an additive to intrathecal bupivacaine in patients undergoing cesarean section.
Khezri MB, Ghasemi J, Mohammadi N.
Acta Anaesthesiol Taiwan. 2013 Dec;51(4):155-60.
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A double-blind comparison of intrathecal S(+) ketamine and fentanyl combined with bupivacaine 0.5% for Caesarean delivery.
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Eur J Anaesthesiol. 2006 Dec;23(12):1018-24.
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Binsted 1983
Epidural morphine after caesarean section.
Binsted RJ.
Anaesth Intensive Care 1983;11(2):130-134.
http://www.ncbi.nlm.nih.gov/pubmed/6869775
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Analgesic efficacy and adverse effects of epidural morphine compared to parenteral opioids after elective caesarean section: a systematic review.
Bonnet MP, Mignon A, Mazoit JX, Ozier Y, Marret E.
Eur J Pain 2010;14(9):894.e1-9
http://www.ncbi.nlm.nih.gov/pubmed/20381390
Camann et al 1992
Does epidural administration of butorphanol offer any clinical advantage over the intravenous route? A double-blind, placebo-controlled trial.
Camann WR, Loferski BL, Fanciullo GJ, Stone ML, Datta S.
Anesthesiology 1992;76(2):216-220
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The role of epidural morphine in the postcesarean patient: efficacy and effects on bonding.
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Anesthesiology. 1983 Jun;58(6):500-4.
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The primary action of epidural fentanyl after cesarean delivery is via a spinal mechanism.
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Anesth Analg. 2002 Mar;94(3):674-9
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Extradural fentanyl for postoperative analgesia: predominant spinal or systemic action?
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Patient-controlled analgesia: epidural fentanyl and i.v. morphine compared after caesarean section.
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A comparison of epidural and intramuscular morphine in patients following cesarean section.
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Patient-controlled analgesia after cesarean delivery: Epidural sufentanil versus intravenous morphine
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Regional Anesthesia, 1994;19(2):90-97
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Analgesia following extradural and i.m. pethidine in post-caesarean section patients.
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Double-blind comparison of epidural diamorphine and intramuscular morphine after elective caesarean section, with computerised analysis of continuous pulse oximetry.
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A comparison of epidural diamorphine with intravenous patient-controlled analgesia using the Baxter infusor following caesarean section.
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Motor block during patient-controlled epidural analgesia with ropivacaine or ropivacaine/fentanyl after intrathecal bupivacaine for caesarean section.
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Epidural analgesia for post-caesarean pain relief: a comparison between morphine and fentanyl.
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The effect of addition of intrathecal clonidine to hyperbaric bupivacaine on postoperative pain after lower segment caesarean section: A randomized control trial.
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The effect of addition of intrathecal clonidine to hyperbaric bupivacaine on postoperative pain and morphine requirements after Caesarean section: a randomized controlled trial.
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