Is epidural analgesia non‐inferior to intrathecal fentanyl as initiation for neuraxial analgesia in early non‐spontaneous labour?
Authors' conclusion
After 20 min, epidural analgesia by lidocaine and fentanyl was within the non-inferior threshold compared with intrathecal fentanyl in efficacy.
Study context
- Population
- Primiparous parturients with induced labour, early labourrandomised 1:1
- Participants
- 60 participants
- Comparison
- Epidural analgesia vs intrathecal fentanyl 20 μg
- Primary endpoint
- Difference in contraction pain VAS (0-100 mm) between interventions
- Follow-up
- 20 min after analgesia administration
Methodological detailsnon-inferiority
- Non-inferiority
Primary result
Contraction pain VAS · 20 min
Absolute mean difference
3.3 mm
CI −0.06 to 6.66
By group
Epidural analgesia vs Intrathecal fentanyl
absolute mean difference 3.3 mm (CI −0.06 to 6.66)
Non-inferiority margin 20 as printed, not drawn
As reported in the abstract
Further findings
Median time to VAS <30 mm
min
| Outcome | Intrathecal fentanyl | Epidural analgesia | Difference (min) (CI) | |
|---|---|---|---|---|
| Duration until request for supplemental analgesia | 82 (interval 69–95) | 91 (interval 75–106) | 9 (6–12) | |
| −5051015Difference, min (linear scale) |
| Outcome | Difference (mm) (CI) | |
|---|---|---|
| Maternal satisfaction VAS | 0.3 (−3.0 to 3.7) | |
| −4−2024Difference, mm (linear scale) |
Safety
Foetal heart rate abnormalities
- No differences between the groups
Pruritus
- More common after intrathecal fentanyl
Original publication
Is epidural analgesia non‐inferior to intrathecal fentanyl as initiation for neuraxial analgesia in early non‐spontaneous labour? Acta Anaesthesiol Scand. Published 16 February 2024. doi:10.
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