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Comparative study of Remifentanil patient-controlled epidural vs. intravenous labor analgesia

epidural vs. intravenous labor analgesia epidural vs. intravenous labor analgesia
epidural vs. intravenous labor analgesia epidural vs. intravenous labor analgesia

A study was conducted to explore the effectiveness and safety of Remifentanil for patient-controlled intravenous analgesia as a substitute for patient-controlled epidural analgesia for labor pain.

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Key take away

Compared to patient-controlled epidural analgesia, Remifentanil patient-controlled intravenous analgesia exhibits a considerably lower onset time of labor analgesia.

Background

A study was conducted to explore the effectiveness and safety of Remifentanil for patient-controlled intravenous analgesia as a substitute for patient-controlled epidural analgesia for labor pain.

Method

Overall, 407 of the 453 expectant mothers who volunteered for labor analgesia and were chosen as study participants finished the trial. The recruited subjects were split into the control group (259 volunteers; patient-controlled epidural analgesia) and the research group (148 volunteers). The initial dosage of Remifentanil, background dose, and patient-controlled analgesia dose in the research group were 0.4 μg/kg, 0.04 μg/min, and 0.4 μg/kg, respectively, with a lockout interval of 3 minutes.

Epidural analgesia was administered to the control group. The 1st dose and background dose was 6-8 mL. The patient-controlled analgesia dose and analgesia pump locking time were 5 mL and 20 minutes, respectively. The pain-relieving and sedative effects on the expectant mother, the labor process, cesarean section rate, forceps delivery, noxious responses, and maternal and newborn status were all monitored and documented for the two groups.

Result

As opposed to the control arm, the onset time of pain relief in the research arm was significantly lower, with a clinically meaningful difference (t = –93.979).

The two groups did not vary substantially in terms of the labor process, forceps delivery, cesarean section rate, or newborn health.

Conclusion

Rapid onset of labor analgesia is a benefit of Remifentanil patient-controlled intravenous analgesia. Despite the fact that its analgesic impact is less accurate and stable than epidural patient-controlled labor analgesia, patient-controlled intravenous labor analgesia exhibits a high degree of family and maternal satisfaction.

Source:

Ginekologia Polska

Article:

Clinical study on the effect of Remifentanil patient-controlled intravenous labor analgesia compared to patient-controlled epidural labor analgesia

Authors:

Haibing Li et al.

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