Intraoperative Pain during Cesarean Delivery under Neuraxial Anesthesia: A Systematic Review and Meta-analysis
Authors' conclusion
Patient-reported pain during cesarean delivery under neuraxial anesthesia is common, with spinal and combined spinal-epidural anesthesia reporting a lower incidence of pain than epidural anesthesia.
Study context
- Population
- Patients undergoing cesarean delivery under neuraxial anesthesia34 articles
- Participants
- 11,351 patients
- Comparison
- Modes of neuraxial anesthesia
- Spinal anesthesian = 8,002
- Epidural top-upn = 1,395
- Outcome
- Incidence of patient-reported intraoperative pain
Methodological detailsrisk of bias assessment, High risk of bias in half of the included studies
- Risk of bias assessment
- High risk of bias in half of the included studies
Pooled result
As reported in the abstract
Intraoperative pain under neuraxial anesthesia
Crude incidence (1,229 of 11,351 patients)
10.8%
Pooled incidence
17%
95% CI 13 to 22%
Further pooled results
| Outcome | Spinal anesthesia | Epidural top-up |
|---|---|---|
| Pooled incidence of pain by mode of anesthesiaSpinal lowest, epidural top-up highest pooled incidence | 14% (95% CI 10.0–20.0%) | 33% (95% CI 17.0–54.0%) |
Original publication
Intraoperative Pain during Cesarean Delivery under Neuraxial Anesthesia: A Systematic Review and Meta-analysis. Anesthesiology. Published 4 April 2025. doi:10.
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