Vol 94, No 7 (2023)
Research paper
Published online: 2023-03-21

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

Haibing Li1, Hui Li2, Yibing Yu1, Yan Lu1
Pubmed: 36976870
Ginekol Pol 2023;94(7):544-551.

Abstract

Objectives: This study aims to investigate the safety and efficacy of remifentanil for patient-controlled intravenous labor analgesia as an alternative to the patient-controlled epidural labor analgesia.

Material and Methods: Out of 453 parturients who volunteered for labor analgesia and were selected as research objects, 407 completed the trial. They were divided into the research group (n = 148) and the control group (n = 259; patient-controlled epidural analgesia). In the research group, the first dose of remifentanil, the background dose and the patient- -controlled analgesia (PCA) dose were 0.4 μg/kg, 0.04 μg/min and 0.4 μg/kg, respectively, with a lockout interval of 3 min. The control group was given epidural analgesia. The first dose and background dose were 6–8 mL, and PCA dose and the locking time of analgesia pump were 5 mL and 20 min, respectively. The following indexes of the two groups were observed and recorded: the analgesic and sedative effects on parturient, labor process, forceps delivery, cesarean section rate and adverse reactions, and maternal and neonatal conditions.

Results: (1) The onset time of analgesia in the research group was (0.97 } 0.08) min, which was noticeably shorter than that in the control group ([15.74 } 1.91] min), with a statistically significant difference (t = –93.979, p = 0.000). (2) There was no significant difference in the labor process, forceps delivery, cesarean section rate and neonatal condition between the two groups (p > 0.05).

Conclusions: Remifentanil patient-controlled intravenous labor analgesia has the advantage of rapid onset of labor analgesia. Although its analgesic effect is not as accurate and stable as epidural patient-controlled labor analgesia, it shows a high level of maternal and family satisfaction.

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