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Reviews
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What are the main claims of the paper and how important are they?
The authors have conducted a systematic review and metaanalysis regarding safety and effectiveness of inhaled analgesics for labour pains.
Drugs used for inhaled analgesia for relief of labour pain includes nitrous oxide(N2O),isoflurane,sevoflurane ,trichloroethylene,methoxyflurane,and cyclopropane. They included reports of studies identified by search strategies.Of these 26 studies (reporting data on 2959women)(31reports)were includedand 27 studies (43 reports )were excluded.Effect of inhaled analgesia on pain intensity,pain relief,and pain satisfaction with pain relief .For the safety of inhaled analgesics they studied the effect on assisted vaginal birth,LSCS,nausea,vomiting,drowsiness,amnesis,apgarscore<7 at 5 min.They concluded that inhaled analgesics may bee beneficial for labour pain relief with minimum to moderate effect on A/S of the newbornand advivced further adequate powered randomized controlled trials which include relevant clinical outcomes.
Furtherdifferentiating the advantages of N2O over flurane derivatives they found flurane derivatives not found exclusively used in obstetric wards as cmpred to N2O.However both flurane derivatives and N2O are relatively inexpensive II)AlsoN2O doesn't have relatively sharp smell iii)Main difference is in case of flurane derivativesis administration ,since N2O can be aministered by woman herself with the right equipment and on the other end of spectrum flurane derivatives need to be controlled by well trained anaesthetist.This is to ensure right conc of the agent and preventing unconsciousnessor any other problems.
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Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.
No no already 2 cochrane reviews done on the same titleand then 2 articles systemstic review on ntitrous oxide by itself Jones L,Othmann M,DowswellT etal.Pain management for women in labour:an overview of systematic reviews Cochrane Database Syst Rev 2012 3CD009234.
Komp T,vanPoppelM,Jones LetAL.Inhaled analgesia for pain management in labour.Cochrane Database Syst Rev 2012 9CD009351.
Likis FE,Andrews JC,Collins MR,Lewis RM,Seroogy JM,Staar SA,Walden RR,Macphenters ML.Nitrous oxide for the management of labourpain:asystematic review Anesth Analg 2014;118(1):153-`167.
Dammer U,Weiss C,Rsbe E,Heeinrich J,Kch MC,Winkler M,Fashingbuer F,BeckmannMW,Kehl S.Introduction of inhaled nitrous oxideand oxygen for atients management during labour-evaluation of patients and midwives satisfaction.Geburtshille Frauenhelkd 2014;74(7):656-60.
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Are the claims properly placed in the context of the previous literature?
Yes
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Do the results support the claims? If not, what other evidence is required?
Yes
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If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?
yes the author has properly provided methods for the systematic review and figures to support the metaanalysis
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Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?
yes and it can be reproduced
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Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?
the author has thoroughly conducted the systematic review as well as metaanalysis and whatever flaws were found in the studies were excluded from their analysis
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Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?
NOT OUTSTANDING IN THE SENSE AS THE WORK IS ALREADY KNOWN ALTHOUGH THE AUTHOR HAS COVERED IT WELL BUT DOESNT WARRRANT PRESENTATION
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Other Comments:
SINCE THE AUTHOR HAS BEEN DEALING MAINLY WITH INHALED ANALGESICS HE HAS HIGHLIGHTED ON THE ADVANTAGES OF NITROUSOXIDE OVER FLURANES and not compared why some patients find epidural anaesthesia uncomfortable although he has touched in the introduction segment the other methods which can be ued like TENS etc
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Invited by the author to review this article? :
Yes -
Have you previously published on this or a similar topic?:
No
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References:
None -
Experience and credentials in the specific area of science:
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- How to cite: Kaur K K.Safety and effectiveness of inhaled analgesia for labour pain[Review of the article 'Safety and effectiveness of inhaled analgesia for labour pain ' by Alhawsah M].WebmedCentral 2015;6(9):WMCRW003242
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This study comprises of a metaanalysis of 26 studies with pooled data on 2959 women. The authors have assessed the efficacy and safety of inhaled analgesia for pain relief of laboring women. The effectiveness of inhaled analgesia was assessed by relief of pain and women’s satisfaction with pain relief. The safety of inhaled analgesia was studied by nausea, vomiting, drowsiness, amnesia, rates of vaginal and cesarean births and Apgar score
No; similar studies have already been published with similar results. A Cochrane review published in 2012 by Komp T et al. has reported on the same studies including same number of women with similar results.
Ref: Klomp T, van Poppel M, Jones L, Lazet J, Di Nisio M, Lagro-Janssen ALM. Inhaled analgesia for pain management in labour. Cochrane Database of Systematic Reviews 2012, Issue 9. Art. No.: CD009351. DOI: 10.1002/14651858.CD009351.pub2
Yes
Yes
Yes
Yes, but it would help if the authors also disclose the names of databases that were searched and include the search phrases. The details of hand searches of library resources for relevant papers, books, abstracts, and conference proceedings etc. should be provided and whether any authors were contacted to provide relevant data especially in cases of non-English literature.
No
No
None
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Yes
No
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