ReviewCanadian family physician Medecin de famille canadien2007
Single-dose intrathecal analgesia to control labour pain: is it a useful alternative to epidural analgesia?
Review in Canadian family physician Medecin de famille canadien, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03117595 (Combined Spinal Epidural Analgesia in Labour), which is not on this map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Combined Spinal Epidural Analgesia in Labour: A Comparison of Two Intrathecal Regimens of Single Shot Spinal
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pain management for women in labour: an overview of systematic reviews.The Cochrane database of systematic reviews · 2012Pooled it
- Analgesic Efficacy and Safety of Intrathecal Morphine in Surgical Patients: A Narrative Review.Cureus · 2026Review
- Patient Satisfaction With Single-Shot Spinal Analgesia for Labor: A Single-Center Study.Cureus · 2025Article
- Safety and Efficiency of Low-Dose Spinal Analgesia Compared to Epidural Analgesia in Treatment of Pain during Labour: A Case Control Study.Journal of clinical medicine · 2023Article
- The Effect of Painless Delivery with Intrathecal Sufentanil on Labor Progress and Neonatal Outcomes: A Single Center Study on Pregnant Women.Anesthesiology and pain medicine · 2022Article
- Fentanyl for labour pain management: a scoping review.BMC pregnancy and childbirth · 2022Article
- Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia.Anesthesiology and pain medicine · 2021Article
- Comparison of Spinal Versus Epidural Analgesia for Vaginal Delivery: A Randomized Double Blinded Clinical Trial.Anesthesiology and pain medicine · 2021Article
- Comparison of Intrathecal Injection of Fentanyl and Sufentanil on the Onset, Duration, and Quality of Analgesia in Labor: A Randomized, Double-Blind Clinical Trial.Anesthesiology and pain medicine · 2020Article
- A comparison of the effects of ENTONOX inhalation and spinal anesthesia on labor pain reduction and apgar score in vaginal delivery: a clinical trial study.BioMedicine · 2018Article
- Reduction in labor pain by intrathecal midazolam as an adjunct to sufentanil.Korean journal of anesthesiology · 2014Article
- Advances in labor analgesia.International journal of women's health · 2010Article
- Labour pains.Canadian family physician Medecin de famille canadien · 2008Article
- ITN requires training.Canadian family physician Medecin de famille canadien · 2007Article
Corrections and comments
- Commented on by
- Commented on byLabour pains.2008
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the safety and efficacy of single-dose spinal analgesia (intrathecal narcotics [ITN]) during labour. QUALITY OF EVIDENCE: MEDLINE was searched and the references of 2 systematic reviews and a meta-analysis were reviewed to find articles on obstetric analgesia and pain measurement. The 33 articles selected included 14 studies, 1 meta-analysis, and 2 systematic reviews, all providing level I evidence. MAIN MESSAGE: The literature supports use of ITN as a safe and effective alternative to epidural anesthesia. The recent decrease in rates of episiotomies and use of forceps during deliveries means patients require less dense perineal anesthesia. The advantage of single-dose ITN is that fewer physicians and nurses are needed to administer it even though its safety and effectiveness are comparable with other analgesics. Use of ITN is associated with a shorter first stage of labour and more rapid cervical dilation. A combination of 2.5 mg of bupivacaine, 25 microg of fentanyl, and 250 microg of morphine intrathecally usually provides a 4-hour window of acceptable analgesia for patients without complications not anticipating protracted labour. The evolution in dosing of ITN warrants a re-examination of its usefulness in modern obstetric practice.
conclusionPhysicians practising modern obstetrics in rural and small urban centres might find single-dose ITN a useful alternative to parenteral or epidural analgesia for appropriately selected patients.
Indexed as
Identifiers
17872679PMC1949078What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.