Management of Pain After Cesarean Delivery Without Intrathecal Morphine: Networking for the Best Answer
Bibliographic record
Abstract
(Can J Anesth/J Can Anesth. 2020;67:1704–1709) Acute pain after cesarean delivery (CD) is a predictor of important short-term and long-term outcomes including postpartum depression. Intrathecal opioids are often provided as post-CD analgesia following CD using neuraxial analgesia. However, when spinal anesthesia or intrathecal morphine are not good options, truncal blocks and local anesthetic wound infiltration (WI) are possible alternatives. Common truncal blocks used in this context include the transversus abdominis plane (TAP) block or quadratus lumborum block (QLB). A recent network meta-analysis (NMA) by Sultan et al compared single-injection TAP block, single-dose WI and continuous wound catheter (WC) in terms of 24-hour opioid consumption. TAP block and WC showed lower opioid consumption and pain scores that WI or inactive control. TAP block also had a longer time-to-first analgesic request than inactive controls.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.032 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.004 | 0.008 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.007 |
| Insufficient payload (model declined to judge) | 0.024 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".