{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:45:42Z","timestamp":1786977942443,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T00:00:00Z","timestamp":1669593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Epidural clonidine improves analgesia but may induce adverse effects in labor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the efficacy and safety of epidural clonidine as local anesthetics (LA) adjuvant by continuous infusion or patient\u2010controlled epidural analgesia (PCEA) in labor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Search Strategy<\/jats:title>\n                    <jats:p>PubMed, Embase, Web of Science, and CENTRAL were searched from inception to May 10, 2022 without language restriction; references of the retrieved studies were hand searched.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Selection Criteria<\/jats:title>\n                    <jats:p>Randomized controlled trials (RCTs) comparing epidural LA with and without clonidine using continuous infusion or PCEA in labor were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Collection and Analysis<\/jats:title>\n                    <jats:p>A random effects model was used to pool the data on analgesia and adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>Eight RCTs were included. Clonidine did not reduce the incidence of parturients requiring additional epidural boluses but reduced LA consumption and pain scores without increasing adverse effects, except for a higher incidence of instrumental delivery when clonidine was combined with LA and opioid (risk ratio 2.38, 95% confidence interval 1.26\u20134.50). Clonidine offered similar analgesia to opioids but had reduced opioid\u2010related adverse effects. Trial sequential analysis showed that the evidence was insufficient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Epidural clonidine by continuous infusion or PCEA does not increase significant adverse effects and offers similar analgesia to opioids in labor. PROSPERO registration no. CRD42022306565.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.14579","type":"journal-article","created":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T08:59:15Z","timestamp":1668502755000},"page":"726-737","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy and safety of epidural clonidine by continuous infusion or patient\u2010controlled analgesia in labor: A meta\u2010analysis of randomized controlled trials"],"prefix":"10.1002","volume":"161","author":[{"given":"Feng","family":"Xia","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Jiaxing Maternity and Children Health Care Hospital, Affiliated Women and Children Hospital, Jiaxing University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2654-5178","authenticated-orcid":false,"given":"Li\u2010Zhong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Jiaxing Maternity and Children Health Care Hospital, Affiliated Women and Children Hospital, Jiaxing University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang\u2010Yang","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Jiaxing Maternity and Children Health Care Hospital, Affiliated Women and Children Hospital, Jiaxing University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin\u2010Fa","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Jiaxing Maternity and Children Health Care Hospital, Affiliated Women and Children Hospital, Jiaxing University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,28]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"CD000331","article-title":"Epidural versus non\u2010epidural or no analgesia for pain management in labour","volume":"5","author":"Anim\u2010Somuah M","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000183"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000002182"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-015-0386-5"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2019.06.001"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200209000-00036"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2009.08.003"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200209000-00037"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199302000-00011"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00115550-200001000-00002"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1098-7339(98)90075-X"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"e_1_2_8_14_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (Updated March 2011)","author":"JPT H","year":"2011"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/82.3.371"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200312000-00017"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280216669183"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-017-0315-7"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2011.06785.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.56126\/71.2.4"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00115550-200001000-00007"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-006-0476-8"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000000347"},{"issue":"2","key":"e_1_2_8_25_1","article-title":"The comparison of efficiency of ropivacaine and addition of fentanyl or clonidine in patient controlled epidural analgesia for labour","volume":"11","author":"Topcu I","year":"2006","journal-title":"Internet J Anesthesiology"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/83.2.257"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0b013e3283365944"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2018.01.001"},{"key":"e_1_2_8_29_1","first-page":"CD011344","article-title":"Automated mandatory bolus versus basal infusion for maintenance of epidural analgesia in labour","volume":"5","author":"Sng BL","year":"2018","journal-title":"Cochrane Database Syst Rev"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.14579","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.14579","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.14579","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T08:01:03Z","timestamp":1692432063000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.14579"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,28]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1002\/ijgo.14579"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.14579","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,28]]},"assertion":[{"value":"2022-09-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}