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In women with labor pain, Remifentanil patient-controlled analgesia and epidural analgesia have comparable analgesic effects.
According to a meta-analysis and systematic review, Remifentanil patient-controlled analgesia can be used as an optional substitute for epidural analgesia for pain relief. It exhibits equivalent analgesic effects without lowering maternal satisfaction with pain management and without escalating adverse neonatal outcomes. Researchers sought to compare the safety and effectiveness of Remifentanil patient-controlled analgesia against epidural analgesia in labor.
Databases such as Weipu, Wanfang, China National Knowledge Infrastructure (CNKI), Cochrane Library, ScienceDirect, EMBASE, and PubMed were explored for randomized controlled trials (RCTs) contrasting Remifentanil patient-controlled analgesia and epidural analgesia in labor. Two researchers independently reviewed the literature. This was followed by data collection. For data analysis, RevMan 5.3 software was utilized.
A total of 3086 parturients were included in a total of ten RCTs; 1549 of them got Remifentanil patient-controlled analgesia, while 1537 received epidural analgesia. According to the meta-analysis, the occurrence of intrapartum maternal fever in the Remifentanil patient-controlled analgesia was considerably lower than that of epidural analgesia within the first hour of labor analgesia (OR = 0.43) and after 1 hour of labor analgesia (OR = 0.42).
In comparison to epidural analgesia, the incidence of respiratory depression (OR = 3.56) was considerably greater in the Remifentanil patient-controlled analgesia group. No profound inter-group difference was noted in the incidence of Apgar scores of < 7 at 5 minutes (OR = 1.18) and the patient's satisfaction with labor analgesia (SMD = 0.03).
With comparable pain alleviation and a lower risk of intrapartum maternal fever, Remifentanil patient-controlled analgesia can be used as an optional substitute for epidural analgesia. But, Remifentanil patient-controlled analgesia was linked to a greater chance of respiratory depression. Future research with a bigger sample size and a rigorous methodology is required to offer more robust data for the Remifentanil patient-controlled analgesia and epidural analgesia use.
PLoS One
The efficacy and safety of remifentanil patient-controlled versus epidural analgesia in labor: A meta-analysis and systematic review
Xiuzhen Lei et al.
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