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Epidural Analgesia with Amide Local Anesthetics, Bupivacaine, and Ropivacaine in Combination with Fentanyl for Labor Pain Relief: A Meta-Analysis

BACKGROUND: The study compares the effectiveness of bupivacaine and fentanyl (BUPI-FEN) and ropivacaine and fentanyl (ROPI-EFN) in epidural analgesia for labor pain through a meta-analysis of relevant randomized clinical trials. MATERIAL/METHODS: Multiple electronic databases were searched using app...

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Autores principales: Li, Yiyang, Hu, Cong, Fan, Yanyan, Wang, Huixia, Xu, Hongmei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4395021/
https://www.ncbi.nlm.nih.gov/pubmed/25816849
http://dx.doi.org/10.12659/MSM.892276
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author Li, Yiyang
Hu, Cong
Fan, Yanyan
Wang, Huixia
Xu, Hongmei
author_facet Li, Yiyang
Hu, Cong
Fan, Yanyan
Wang, Huixia
Xu, Hongmei
author_sort Li, Yiyang
collection PubMed
description BACKGROUND: The study compares the effectiveness of bupivacaine and fentanyl (BUPI-FEN) and ropivacaine and fentanyl (ROPI-EFN) in epidural analgesia for labor pain through a meta-analysis of relevant randomized clinical trials. MATERIAL/METHODS: Multiple electronic databases were searched using appropriate MeSH terms and keywords for original English language research papers published between 1990 and March 2014. Meta-analyses results were based on the mean differences between the groups as well as odds ratios where appropriate. Statistical heterogeneity amongst the included studies was tested by I(2) index. RESULTS: Nine studies that met the inclusion criteria were selected for analysis which consisted of 556 parturient patients. The duration of the second stage of labor was significantly shorter in the BUPI-FEN group by a mean of −6.87 (−10.98, −2.77; P<0.002). On the other hand, the ROPI-FEN group had a significantly lower incidence of motor blockade by a mean of 0.31 (0.18, 0.51; P<0.00001). A positive relationship between the amide local anesthetic concentration and the number of women having motor blockade was observed, but a negative relationship between fentanyl concentration and the number of women experiencing a motor block. Moreover, a positive correlation was found between the concentration of ropivacaine and the incidence of instrumental delivery and between the concentration of bupivacaine and the incidence of cesarean delivery. CONCLUSIONS: In combination with fentanyl, bupivacaine and ropivacaine exhibit comparable efficacy and safety. However, BUP-FEN analgesia led to a shortened second-stage labor and ROPI-FEN resulted in a significantly lower incidence of motor block.
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spelling pubmed-43950212015-04-16 Epidural Analgesia with Amide Local Anesthetics, Bupivacaine, and Ropivacaine in Combination with Fentanyl for Labor Pain Relief: A Meta-Analysis Li, Yiyang Hu, Cong Fan, Yanyan Wang, Huixia Xu, Hongmei Med Sci Monit Meta-Analysis BACKGROUND: The study compares the effectiveness of bupivacaine and fentanyl (BUPI-FEN) and ropivacaine and fentanyl (ROPI-EFN) in epidural analgesia for labor pain through a meta-analysis of relevant randomized clinical trials. MATERIAL/METHODS: Multiple electronic databases were searched using appropriate MeSH terms and keywords for original English language research papers published between 1990 and March 2014. Meta-analyses results were based on the mean differences between the groups as well as odds ratios where appropriate. Statistical heterogeneity amongst the included studies was tested by I(2) index. RESULTS: Nine studies that met the inclusion criteria were selected for analysis which consisted of 556 parturient patients. The duration of the second stage of labor was significantly shorter in the BUPI-FEN group by a mean of −6.87 (−10.98, −2.77; P<0.002). On the other hand, the ROPI-FEN group had a significantly lower incidence of motor blockade by a mean of 0.31 (0.18, 0.51; P<0.00001). A positive relationship between the amide local anesthetic concentration and the number of women having motor blockade was observed, but a negative relationship between fentanyl concentration and the number of women experiencing a motor block. Moreover, a positive correlation was found between the concentration of ropivacaine and the incidence of instrumental delivery and between the concentration of bupivacaine and the incidence of cesarean delivery. CONCLUSIONS: In combination with fentanyl, bupivacaine and ropivacaine exhibit comparable efficacy and safety. However, BUP-FEN analgesia led to a shortened second-stage labor and ROPI-FEN resulted in a significantly lower incidence of motor block. International Scientific Literature, Inc. 2015-03-29 /pmc/articles/PMC4395021/ /pubmed/25816849 http://dx.doi.org/10.12659/MSM.892276 Text en © Med Sci Monit, 2015 This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License
spellingShingle Meta-Analysis
Li, Yiyang
Hu, Cong
Fan, Yanyan
Wang, Huixia
Xu, Hongmei
Epidural Analgesia with Amide Local Anesthetics, Bupivacaine, and Ropivacaine in Combination with Fentanyl for Labor Pain Relief: A Meta-Analysis
title Epidural Analgesia with Amide Local Anesthetics, Bupivacaine, and Ropivacaine in Combination with Fentanyl for Labor Pain Relief: A Meta-Analysis
title_full Epidural Analgesia with Amide Local Anesthetics, Bupivacaine, and Ropivacaine in Combination with Fentanyl for Labor Pain Relief: A Meta-Analysis
title_fullStr Epidural Analgesia with Amide Local Anesthetics, Bupivacaine, and Ropivacaine in Combination with Fentanyl for Labor Pain Relief: A Meta-Analysis
title_full_unstemmed Epidural Analgesia with Amide Local Anesthetics, Bupivacaine, and Ropivacaine in Combination with Fentanyl for Labor Pain Relief: A Meta-Analysis
title_short Epidural Analgesia with Amide Local Anesthetics, Bupivacaine, and Ropivacaine in Combination with Fentanyl for Labor Pain Relief: A Meta-Analysis
title_sort epidural analgesia with amide local anesthetics, bupivacaine, and ropivacaine in combination with fentanyl for labor pain relief: a meta-analysis
topic Meta-Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4395021/
https://www.ncbi.nlm.nih.gov/pubmed/25816849
http://dx.doi.org/10.12659/MSM.892276
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