open access

Vol 47, No 1 (2015)
Review articles
Submitted: 2015-03-06
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Remifentanil for labour pain relief

Joanna Solek-Pastuszka, Edyta Zagrodnik-Ulan, Romuald Bohatyrewicz, Zbigniew Celewicz
DOI: 10.5603/AIT.2015.0008
·
Anaesthesiol Intensive Ther 2015;47(1):82-86.

open access

Vol 47, No 1 (2015)
Review articles
Submitted: 2015-03-06

Abstract

Labour is thought to be one of the most intense and painful experiences in a woman’s life. Numerous studies using a Visual Analogue Scale invariably demonstrate that 20% of women in labour describe the pain as “unbearable” and 60% describe the pain as “very intense”. Since the mid-1980s, continuous epidural analgesia during labour has been considered the gold standard of labour anaesthesia and is currently the most frequently used. There are situations in which this type of analgesia could not be used. An alternative pain management is administration of parenteral opioids, the most frequently used of which is pethidine. Its use is associated with adverse effects and unsatisfactory analgesia. Since the second half of the 20th century, a new generation of opioids, such as fentanyl or remifentanil, has been used. Despite their much better pharmacokinetic and pharmacodynamic parameters, obstetricians, midwives and neonatologists are most aware of pethidine, probably because it has been used for the longest period of time, despite its disadvantages and the risk that its use entails. The drug that is nearest to ideal is remifentanil. The countries in which it is widely used as an alternative type of labour anaesthesia have developed practice standards or guidelines practice. Guidelines and alternatives to pethidine protocols for effective labour analgesia in Poland might be merited.

Abstract

Labour is thought to be one of the most intense and painful experiences in a woman’s life. Numerous studies using a Visual Analogue Scale invariably demonstrate that 20% of women in labour describe the pain as “unbearable” and 60% describe the pain as “very intense”. Since the mid-1980s, continuous epidural analgesia during labour has been considered the gold standard of labour anaesthesia and is currently the most frequently used. There are situations in which this type of analgesia could not be used. An alternative pain management is administration of parenteral opioids, the most frequently used of which is pethidine. Its use is associated with adverse effects and unsatisfactory analgesia. Since the second half of the 20th century, a new generation of opioids, such as fentanyl or remifentanil, has been used. Despite their much better pharmacokinetic and pharmacodynamic parameters, obstetricians, midwives and neonatologists are most aware of pethidine, probably because it has been used for the longest period of time, despite its disadvantages and the risk that its use entails. The drug that is nearest to ideal is remifentanil. The countries in which it is widely used as an alternative type of labour anaesthesia have developed practice standards or guidelines practice. Guidelines and alternatives to pethidine protocols for effective labour analgesia in Poland might be merited.

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Keywords

labour, pain, analgesia; opioids, remifentanil

About this article
Title

Remifentanil for labour pain relief

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 47, No 1 (2015)

Pages

82-86

DOI

10.5603/AIT.2015.0008

Bibliographic record

Anaesthesiol Intensive Ther 2015;47(1):82-86.

Keywords

labour
pain
analgesia
opioids
remifentanil

Authors

Joanna Solek-Pastuszka
Edyta Zagrodnik-Ulan
Romuald Bohatyrewicz
Zbigniew Celewicz

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