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. 2004 Apr 19;2004(2):CD003765. doi: 10.1002/14651858.CD003765.pub2

4. Need for additional pain relief during surgery.

study spinal epidural operation duration
Alahuhta 11 patients required pethidine ‐ median 59.5 mg (range 25‐100 mg). 
 VAS asked frequently during course of surgery 11 patients required pethidine ‐ median 49.1 mg (range 25‐80 mg). 
 VAS asked frequently during course of surgery not mentioned
Ledan 3 patients required 50/50 mixture of oxygen/nitrous oxide. Given when anaesthetic quality was insufficient 2 patients required 50/50 mixture of oxygen/nitrous oxide. Given when anaesthetic quality was insufficient 55 +‐ 11 minutes
Olofsson 8 patients required pethidine. 
 Pain intensity and discomfort was rated using numerical rating scales at defined intervals during surgery, i.e. skin incision, uterine incision, delivery, uterine exteriorization, and peritoneal closure 10 patients required pethidine. 
 Pain intensity and discomfort was rated using numerical rating scales at defined intervals during surgery, i.e. skin incision, uterine incision, delivery, uterine exteriorization, and peritoneal closure not mentioned
Vegfors 1 patients required fentanyl, given when patients complained of discomfort 6 patients required fentanyl, given when patients complained of discomfort not mentioned
DATA NOT USED      
Erbay   "Higher anaesthetic requirement" ?additional epidural boluses  
Lertakyamanee About "one‐fifths" of patients required additional analgesia About "one‐fifths" of patients required additional analgesia