Asian Journal Of Social Pharmacy

Abstract: Objective To re-evaluate the systematic review of the safety and effectiveness of epidural analgesia (EA) for labor analgesia. Methods The Cochrane database, PubMed, EMBASE, EBSCO, Web of Science, ScienceDirect, China Biomedical Literature database, CNKI, Wanfang and VIP databases were searched, and the search time was limited to August 2020. Two researchers screened the literature and extracted data according to the inclusion criteria. AMSTAR was used to evaluate the methodological quality of the included studies. Pain intensity and pain relief satisfaction were used as the main indicators for re-evaluation of the effectiveness. Midwifery rate, cesarean section rate, back pain, fever, nausea and vomiting, umbilical artery pH value, and newborn Apgar score were used as the main indicators to re-evaluate the safety. Results and Conclusion A total of 9 meta-analyses were included. The safety and effectiveness of EA and opioid intravenous analgesia, acupuncture stimulation, inhalation analgesia, no analgesia, and continuous delivery were evaluated separately. The included systematic reviews showed that EA could increase the rate of device-assisted delivery, causing maternal fever, and prolonging the first and second stages of labor. But the incidence of back pain, nausea, and vomiting was lower. Therefore, analgesia had a good effect with better satisfactory degree. Current evidence shows that EA is safe and effective for labor analgesia, but the quality of the reports of current studies is not high.

Key words: epidural analgesia, opioid intravenous analgesia, non-epidural analgesia, acupuncture stimulation, inhalation analgesia, continuous care, labor analgesia, systematic review re-evaluation