Efficacy of Intrathecal Fentanyl for Cesarean Delivery: A Systematic Review and Meta-analysis of Randomized Controlled Trials With Trial Sequential Analysis
Bibliographic record
Abstract
(Anesth Analg. 2020;130:111–125) Cesarean delivery procedures have become more popular over the past few decades, and spinal anesthesia is a commonly used method of anesthesia for that operation. A majority of surveyed members of the Society for Obstetric Anesthesia and Perinatology stated that they preferred to administer hyperbaric 0.75% bupivacaine spinal anesthesia for cesarean deliveries, while a smaller percentage of anesthesiologists reported adding fentanyl, morphine, or a combination of both to an intrathecal bupivacaine solution. The addition of intrathecal opioids to spinal anesthesia medication has been reported to be effective for pain relief in some cases, but researchers are still unsure of the benefits, drawbacks, and optimal dosages of these medications. These investigators conducted their systematic review and meta-anlaysis to analyze the effectiveness of fentanyl both alone and in combination with morphine when added to intrathecal bupivacaine anesthesia during a cesarean delivery.
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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 | 0.013 | 0.033 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.028 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
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".