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. 2023 Jun 5;2023(6):CD011344. doi: 10.1002/14651858.CD011344.pub3

Comparison 1. Automated mandatory bolus vs basal infusion.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1.1 Breakthrough pain 16 1528 Risk Ratio (M‐H, Random, 95% CI) 0.71 [0.55, 0.91]
1.2 Breakthrough pain (epidural vs CSE) 15 1450 Risk Ratio (M‐H, Random, 95% CI) 0.73 [0.56, 0.94]
1.2.1 Epidural 8 966 Risk Ratio (M‐H, Random, 95% CI) 0.72 [0.52, 1.01]
1.2.2 CSE 7 484 Risk Ratio (M‐H, Random, 95% CI) 0.71 [0.44, 1.13]
1.3 Breakthrough pain (PCEA vs no PCEA) 16 1528 Risk Ratio (M‐H, Random, 95% CI) 0.71 [0.55, 0.91]
1.3.1 PCEA 9 1071 Risk Ratio (M‐H, Random, 95% CI) 0.76 [0.54, 1.07]
1.3.2 No PCEA 7 457 Risk Ratio (M‐H, Random, 95% CI) 0.65 [0.44, 0.98]
1.4 Breakthrough pain (nulliparous vs nulliparous + multiparous) 16 1528 Risk Ratio (M‐H, Random, 95% CI) 0.71 [0.55, 0.91]
1.4.1 Nulliparous 11 927 Risk Ratio (M‐H, Random, 95% CI) 0.71 [0.49, 1.01]
1.4.2 Nulliparous + multiparous 5 601 Risk Ratio (M‐H, Random, 95% CI) 0.67 [0.49, 0.93]
1.5 Caesarean delivery 16 1735 Risk Ratio (M‐H, Random, 95% CI) 0.85 [0.69, 1.06]
1.6 Caesarean delivery (epidural vs CSE) 15 1657 Risk Ratio (M‐H, Random, 95% CI) 0.85 [0.69, 1.06]
1.6.1 Epidural 9 1215 Risk Ratio (M‐H, Random, 95% CI) 0.77 [0.60, 1.00]
1.6.2 CSE 6 442 Risk Ratio (M‐H, Random, 95% CI) 1.08 [0.73, 1.59]
1.7 Caesarean delivery (PCEA vs no PCEA) 16 1735 Risk Ratio (M‐H, Random, 95% CI) 0.85 [0.69, 1.06]
1.7.1 PCEA 10 1320 Risk Ratio (M‐H, Random, 95% CI) 0.91 [0.71, 1.18]
1.7.2 No PCEA 6 415 Risk Ratio (M‐H, Random, 95% CI) 0.73 [0.50, 1.07]
1.8 Caesarean delivery (nulliparous vs nulliparous + multiparous) 16 1735 Risk Ratio (M‐H, Random, 95% CI) 0.85 [0.69, 1.06]
1.8.1 Nulliparous 11 1134 Risk Ratio (M‐H, Random, 95% CI) 0.90 [0.69, 1.17]
1.8.2 Nulliparous + multiparous 5 601 Risk Ratio (M‐H, Random, 95% CI) 0.77 [0.54, 1.11]
1.9 Instrumental delivery 17 4550 Risk Ratio (M‐H, Random, 95% CI) 0.85 [0.71, 1.01]
1.10 Instrumental delivery (epidural vs CSE) 16 4472 Risk Ratio (M‐H, Random, 95% CI) 0.84 [0.71, 1.01]
1.10.1 Epidural 10 4030 Risk Ratio (M‐H, Random, 95% CI) 0.88 [0.73, 1.06]
1.10.2 CSE 6 442 Risk Ratio (M‐H, Random, 95% CI) 0.59 [0.33, 1.05]
1.11 Instrumental delivery (PCEA vs No PCEA) 17 4550 Risk Ratio (M‐H, Random, 95% CI) 0.85 [0.71, 1.01]
1.11.1 No PCEA 6 415 Risk Ratio (M‐H, Random, 95% CI) 1.05 [0.66, 1.67]
1.11.2 PCEA 11 4135 Risk Ratio (M‐H, Random, 95% CI) 0.82 [0.68, 0.99]
1.12 Instrumental delivery (nulliparous vs nulliparous + multiparous) 17 4550 Risk Ratio (M‐H, Random, 95% CI) 0.85 [0.71, 1.01]
1.12.1 Nulliparous 12 3949 Risk Ratio (M‐H, Random, 95% CI) 0.82 [0.68, 1.00]
1.12.2 Nulliparous + multiparous 5 601 Risk Ratio (M‐H, Random, 95% CI) 1.02 [0.65, 1.58]
1.13 Duration of labour analgesia in minutes 17 4544 Mean Difference (IV, Random, 95% CI) ‐8.81 [‐19.38, 1.77]
1.14 Duration of labour analgesia in minutes (epidural vs CSE) 16 4473 Mean Difference (IV, Random, 95% CI) ‐7.68 [‐18.08, 2.71]
1.14.1 Epidural 10 4031 Mean Difference (IV, Random, 95% CI) ‐4.31 [‐15.87, 7.24]
1.14.2 CSE 6 442 Mean Difference (IV, Random, 95% CI) ‐31.62 [‐60.92, ‐2.32]
1.15 Duration of labour analgesia in minutes (PCEA vs no PCEA) 17 4544 Mean Difference (IV, Random, 95% CI) ‐8.81 [‐19.38, 1.77]
1.15.1 PCEA 11 4129 Mean Difference (IV, Random, 95% CI) ‐8.51 [‐18.92, 1.91]
1.15.2 No PCEA 6 415 Mean Difference (IV, Random, 95% CI) ‐26.52 [‐69.42, 16.39]
1.16 Duration of labour analgesia in minutes (nulliparous vs nulliparous + multiparous) 17 4544 Mean Difference (IV, Random, 95% CI) ‐8.81 [‐19.38, 1.77]
1.16.1 Nulliparous 12 3943 Mean Difference (IV, Random, 95% CI) ‐10.72 [‐19.97, ‐1.48]
1.16.2 Nulliparous + multiparous 5 601 Mean Difference (IV, Random, 95% CI) 14.65 [‐38.13, 67.43]
1.17 LA consumption per hour 16 1642 Mean Difference (IV, Random, 95% CI) ‐0.84 [‐1.29, ‐0.38]
1.18 LA consumption per hour (epidural vs CSE) 15 1564 Mean Difference (IV, Random, 95% CI) ‐0.84 [‐1.33, ‐0.36]
1.18.1 Epidural 8 1080 Mean Difference (IV, Random, 95% CI) ‐1.22 [‐1.75, ‐0.69]
1.18.2 CSE 7 484 Mean Difference (IV, Random, 95% CI) ‐0.36 [‐0.82, 0.10]
1.19 LA consumption per hour (PCEA vs no PCEA) 16 1642 Mean Difference (IV, Random, 95% CI) ‐0.84 [‐1.29, ‐0.38]
1.19.1 PCEA 10 1262 Mean Difference (IV, Random, 95% CI) ‐0.95 [‐1.19, ‐0.71]
1.19.2 No PCEA 6 380 Mean Difference (IV, Random, 95% CI) ‐0.90 [‐1.85, 0.06]
1.20 LA consumption per hour (nulliparous vs nulliparous + multiparous) 16 1642 Mean Difference (IV, Random, 95% CI) ‐0.84 [‐1.29, ‐0.38]
1.20.1 Nulliparous 12 1118 Mean Difference (IV, Random, 95% CI) ‐0.66 [‐1.14, ‐0.19]
1.20.2 Nulliparous + multiparous 4 524 Mean Difference (IV, Random, 95% CI) ‐1.89 [‐3.67, ‐0.11]