• Anaesthesia · Mar 2013

    Randomized Controlled Trial Comparative Study

    Remifentanil for labour analgesia: a double-blinded, randomised controlled trial of maternal and neonatal effects of patient-controlled analgesia versus continuous infusion.

    Remifentanil patient controlled analgesia during labour is more effective and results in less remifentanil consumed than does continuous infusion.

    • M K Shen, Z F Wu, A B Zhu, L L He, X F Shen, J J Yang, and S W Feng.
    • Department of Anaesthesiology, Wuxi Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University, Wuxi, China.
    • Anaesthesia. 2013 Mar 1;68(3):236-44.

    AbstractThis trial aimed to compare the maternal and neonatal effects of remifentanil given by patient-controlled analgesia (PCA) or continuous infusion for labour analgesia. Patient controlled analgesia was administered using increasing stepwise boluses from 0.1 to 0.4 μg.kg(-1) (0.1 μg.kg(-1) increment, 2 min lockout, n = 30). Continuous infusion used rates from 0.05 to 0.2 μg.kg(-1) .min(-1) (0.05 μg.kg(-1) .min(-1) increment, n = 30). Dose increments were given on request. Women reported lowest pain scores (median (IQR [range]) of 3 (2-4 [2-5]) for PCA and 4 (3-5.25 [3-7]) for continuous infusion (p = 0.004) at 60 min after the beginning of analgesia. The mean (SD) remifentanil umbilical vein/maternal artery ratio in the PCA and infusion groups were 0.74 (0.45) vs 0.70 (0.52), respectively (p = 0.776). The mean (SD) umbilical artery/umbilical vein ratios were 0.31 (0.12) vs 0.26 (0.07), respectively (p = 0.088). Maternal and neonatal adverse reactions of remifentanil were similar between the two groups. The total remifentanil consumption (median (IQR [range]) during PCA administration was lower than continuous infusion, 1.34 (1.22-1.48 [0.89-1.69]) mg vs 1.49 (1.35-1.61 [1.12-1.70] mg; p = 0.011). The results suggest that remifentanil PCA provides better pain relief and similar placental transfer compared with continuous infusion.Anaesthesia © 2013 The Association of Anaesthetists of Great Britain and Ireland.

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    This article appears in the collections: Obstetrics and Is remifentanil for labour analgesia safe and effective?.



    Remifentanil patient controlled analgesia during labour is more effective and results in less remifentanil consumed than does continuous infusion.

    Daniel Jolley  Daniel Jolley
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