Abstract:

Objective The aim of this study is to complete a network meta⁃analysis to clarify the best epidural analgesia methods among five popular methods（CEI，PCEA，PIEB，CEI + PCEA，PIEB + PCEA）. Methods This network meta⁃analysis was conducted using the PubMed，EMBASE，Web of Science with the aim of identifying those randomized controlled trials（RCTs）that performed a comparison among five epidural analgesia methods in healthy primiparas. We searched from inception to 3 February 2020.The data were analyzed using ADDIS 1.16.8. Results 34 eligible trials were included，the results of network meta⁃analysis showed that there was no significant difference among the five administration techniques for the incidence of instrumental delivery，VAS score，the risk of hypotension and shivering，and newborns′ Apgar score. For the incidence of cesarean section， CEI + PCEA，PIEB，PIEB + PCEA were outweighed CEI. For the duration of 2nd stage，PCEA was shorter than CEI + PCEA；4. PCEA，PIEB + PCEA had less motor block than CEI，PIEB + PCEA had less motor block than CEI + PCEA，PCEA，PIEB. Conclusions The results of the present study suggest that the 5 epidural analgesia methods are safe and effective. On the basis of current evidence，we considered that CEI may be the least，PIEB + PCEA may be the best.

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