Efficacy and side effects of intravenous remifentanil patient-controlled analgesia used in a stepwise approach for labour: an observational study

A prospective observational study of maternal oxygenation during remifentanil patient‐controlled analgesia use in labour

“…This supports recommendations to administer supplementary oxygen to all women using remifentanil PCA [13,15,17,18], but also reinforces the need for highquality protocols and midwifery training for remifentanil PCA.…”

Commentary to "Remifentanil for labour pain relief"

“…Maintenance of patent airways in an obese patient additionally complicates the situation, creating a real threat to the life of both mother and her unborn child. Therefore, we agree with experts that parenteral opioids should not be used in spontaneous delivery anaesthesia as a routine [4]. In cases of potential contraindications to central blocks, inhalation agents should be considered [11].…”

“…The literature has reported numerous cases (concerning as much as 27% of study participants) in which SpO 2 in mothers dropped to 91−92% and the use of oxygen was necessary [4]. In recent years even more alarming reports have been published.…”

“…However, it should also be pointed out that during the second decade of the 21st century, opinions as to the administration of this drug are no longer so clear [4,9,10].…”

Can Remifentanil Use in Obstetrics be Improved by Optimal Patient-controlled Analgesia Bolus Timing?

“…23 We have used actual weight for our simulations, since remifentanil clearance in pregnant women at term has been found to be rather increased, 24 and actual dose should best be titrated to effect to avoid under-and overdosing. Muchatuta and Kinsella 21 recommended in their editorial a 3 min lockout to avoid a second bolus being given before the maximum respiratory depression of a first bolus has been attained.…”