SynthesisJournal of anesthesia2021
Effects of intrathecal opioids on cesarean section: a systematic review and Bayesian network meta-analysis of randomized controlled trials.
Synthesis in Journal of anesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05533229 (Fentanyl Versus Morphine in Spinal Anesthesia for Caesarian Section - Study on Perioperative Analgesia, Side Effects and Patient 's Satisfaction), which is not on this map. Cited by 13 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.
Fentanyl Versus Morphine in Spinal Anesthesia for Caesarian Section - Study on Perioperative Analgesia, Side Effects and Patient 's Satisfaction
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Comparison of vasopressors for management of hypotension in high-risk caesarean section under neuraxial anesthesia: a systematic review and network meta-analysis.BMC anesthesiology · 2024Pooled it
- Efficacy of fentanyl combined with bupivacaine and morphine for spinal anesthesia during cesarean section: A double-blind randomized controlled trial.The Journal of international medical research · 2025Trial
- Comparison of sequential and mixture injections of opioids and hyperbaric bupivacaine for subarachnoid block for lower segment caesarean section: a randomised controlled study.Irish journal of medical science · 2024Trial
- Intrathecal dexmedetomidine as an adjuvant to plain ropivacaine for spinal anesthesia during cesarean section: a prospective, double-blinded, randomized trial for EDBMC anesthesiology · 2023Trial
- Article
- Postoperative pain management for caesarean section in Denmark: A survey of current clinical practice.Acta anaesthesiologica Scandinavica · 2025Article
- Effect of Bilateral Erector Spinae Plane Block on Postoperative Analgesia in Cesarean Section Under Spinal Anaesthesia: A Prospective Randomized Controlled Trial.Turkish journal of anaesthesiology and reanimation · 2024Article
- Caesarean Delivery: A Narrative Review on the Choice of Neuraxially Administered Opioid and Its Implications for the Multimodal Peripartum Pain Concept.Medicina (Kaunas, Lithuania) · 2024Review
- Emergency Cesarean Section in a Parturient with Ruptured Sinus of Valsalva under Spinal Anesthesia: A Case Report.Acta medica Philippina · 2024Article
- Perioperative Analgesia and Patients' Satisfaction in Spinal Anesthesia for Cesarean Section: Fentanyl Versus Morphine.Journal of clinical medicine · 2023Article
- Reply to "Is opioid free analgesia first choice for cesarean delivery?"Journal of anesthesia · 2023Article
- Interpreting and assessing confidence in network meta-analysis results: an introduction for clinicians.Journal of anesthesia · 2022Review
- Erector spinae plane block in Caesarean sections: A scoping review.Saudi journal of anaesthesiaReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 9 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe aimed to compare the beneficial and harmful effects of opioids used as adjuncts to local anesthetics in patients undergoing cesarean section under spinal anesthesia.
methodsWe searched electronic databases and ClinicalTrials.gov from their inception until March, 2021 without language restrictions. The primary outcome was the complete analgesia duration (Time to VAS > 0). Data were synthesized using the Bayesian random-effects model. Evidence confidence was evaluated using the Confidence In Network Meta-Analysis.
resultsWe identified 66 placebo-controlled randomized controlled trials (RCTs) comprising 4400 patients undergoing elective cesarean section. Compared with the placebo, intrathecal opioids (fentanyl, sufentanil, and morphine) significantly prolonged the analgesia duration by 96, 96, and 190 min, respectively (mean difference). Despite morphine ranking first, opioid efficacy was similar; the results were inconsistent with respect to other analgesic outcomes. Except for diamorphine, all opioids were associated with significant increases in the pruritus incidence. Sufentanil and morphine were associated with increases in the respiratory depression incidence.
conclusionsWe confirmed that intrathecal opioids benefit postoperative analgesia. Although morphine seems to be the most appropriate agent, some results were inconsistent, and the evidence confidence was often moderate or low, especially for adverse outcomes. Well-designed RCTs with an evidence-based approach are imperative for determining the most appropriate opioid for cesarean sections.
Indexed as
Identifiers
What 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.