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

Comparison 1. Spinal versus epidural.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Failure to achieve adequate anaesthesia to begin surgery 4 364 Risk Ratio (M‐H, Random, 95% CI) 0.98 [0.23, 4.24]
1.1 Bupivacaine spinal versus bupivacaine epidural 2 95 Risk Ratio (M‐H, Random, 95% CI) 0.67 [0.04, 12.08]
1.2 Lignocaine spinal versus lignocaine epidural 1 238 Risk Ratio (M‐H, Random, 95% CI) 2.37 [0.94, 5.97]
1.3 Different local anaesthetics used 1 31 Risk Ratio (M‐H, Random, 95% CI) 0.35 [0.02, 8.08]
2 Need for another anaesthetic technique during surgery 1 238 Risk Ratio (M‐H, Random, 95% CI) 1.53 [0.56, 4.15]
3 Need for additional pain relief during surgery 5 504 Risk Ratio (M‐H, Random, 95% CI) 0.88 [0.59, 1.32]
3.1 Bupivacaine spinal versus bupivacaine epidural 3 116 Risk Ratio (M‐H, Random, 95% CI) 0.95 [0.61, 1.50]
3.2 Lignocaine spinal versus lignocaine epidural 1 238 Risk Ratio (M‐H, Random, 95% CI) 1.53 [0.56, 4.15]
3.3 Spinal plus fentanyl versus epidural plus fentanyl 1 50 Risk Ratio (M‐H, Random, 95% CI) 0.5 [0.17, 1.45]
3.4 Different local anaesthetics used 1 100 Risk Ratio (M‐H, Random, 95% CI) 0.17 [0.02, 1.33]
4 Women unsatisfied with anaesthetic 2 258 Risk Ratio (M‐H, Random, 95% CI) 1.00 [0.71, 1.41]
4.1 Bupivacaine spinal versus bupivacaine epidural 1 20 Risk Ratio (M‐H, Random, 95% CI) 0.33 [0.02, 7.32]
4.2 Lignocaine spinal versus lignocaine epidural 1 238 Risk Ratio (M‐H, Random, 95% CI) 1.02 [0.72, 1.43]
5 Maternal satisfaction 2 258 Mean Difference (IV, Random, 95% CI) ‐0.34 [‐0.98, 0.30]
5.1 anaesthetic quality score 1 20 Mean Difference (IV, Random, 95% CI) 0.12 [‐0.93, 1.17]
5.2 satisfaction score 1 238 Mean Difference (IV, Random, 95% CI) ‐0.57 [‐1.27, 0.13]
6 Need for treatment for hypotension 6 495 Risk Ratio (M‐H, Random, 95% CI) 1.23 [1.00, 1.51]
6.1 Bupivacaine spinal versus bupivacaine epidural 3 126 Risk Ratio (M‐H, Random, 95% CI) 1.18 [0.80, 1.76]
6.2 Lignocaine spinal versus lignocaine epidural 1 238 Risk Ratio (M‐H, Random, 95% CI) 1.10 [0.87, 1.39]
6.3 Different local anaesthetics used 2 131 Risk Ratio (M‐H, Random, 95% CI) 1.80 [0.85, 3.83]
7 Any other intervention during surgery 1 46 Risk Ratio (M‐H, Random, 95% CI) 3.0 [0.13, 70.02]
7.1 Nausea and vomiting 1 46 Risk Ratio (M‐H, Random, 95% CI) 3.0 [0.13, 70.02]
8 Treatment for post dural puncture headache 1 20 Risk Ratio (M‐H, Random, 95% CI) 3.0 [0.14, 65.90]
9 Postoperative interventions ‐ need for unplanned pain relief 2 60 Risk Ratio (M‐H, Random, 95% CI) 1.55 [0.67, 3.59]
10 Postoperative interventions ‐ any other intervention 1 55 Risk Ratio (M‐H, Random, 95% CI) 0.65 [0.06, 6.71]
11 Women unable to breastfeed satisfactorily 0 0 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
12 Time to ambulation post‐surgery 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
13 Neonatal intervention required 1 104 Risk Ratio (M‐H, Random, 95% CI) 1.28 [0.30, 5.45]
14 Time for surgery to commence 4 345 Mean Difference (IV, Random, 95% CI) ‐7.91 [‐11.59, ‐4.23]
14.1 Bupivacaine spinal versus bupivacaine epidural 3 107 Mean Difference (IV, Random, 95% CI) ‐11.63 [‐18.27, ‐4.99]
14.2 Lignocaine spinal versus lignocaine epidural 1 238 Mean Difference (IV, Random, 95% CI) ‐1.80 [‐2.78, ‐0.82]