Effects of different neuraxial analgesia modalities on the need for physician interventions in labour: A network meta-analysis
Authors' conclusion
PIEB+PCEA is associated with a lower risk of physician interventions in labour than CEI+PCEA. DPE or CSE and PIEB+PCEA may be associated with a lower likelihood of physician interventions than other neuraxial modalities. Otherwise, the new neuraxial analgesia techniques do not appear to offer significant advantages over traditional techniques.
Study context
- Population
- Healthy labouring women receiving neuraxial labour analgesia
- Participants
- 8,188 participants · 30 studies
- Comparison
- Six neuraxial labour analgesia modalities vs epidural (EPL)+continuous epidural infusion (CEI)+patient-controlled epidural analgesia (PCEA)
- Outcome
- Proportion of women needing physician interventions (physician-administered epidural top-ups for inadequate analgesia)
Pooled result
As reported in the abstract
Odds ratio (95% CrI)
EPL+PIEB+PCEA vs EPL+CEI+PCEACrI
0.44(0.22–0.86)
CSE+PIEB+PCEA vs EPL+CEI+PCEACrI
0.29(0.12–0.71)
DPE+PIEB+PCEA vs EPL+CEI+PCEACrI
0.19(0.08–0.42)
DPE+PIEB+PCEA vs CSE+PIEB+PCEACrI; not significant
0.63(0.25–1.62)
Further pooled results
Local anaesthetic consumption, maximum pain score, instrumental delivery
- No significant differences between the different neuraxial modalities
Original publication
Effects of different neuraxial analgesia modalities on the need for physician interventions in labour: A network meta-analysis. Eur J Anaesthesiol. Published 28 March 2024. doi:10.
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