Patient-Controlled Analgesia Using Remifentanil in the Parturient with Thrombocytopaenia

Jones, Rhys; Pegrum, A.; Stacey, R. G. W.

doi:10.1097/00132582-199909000-00015

Cited by 20 publications

(28 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Pain scores in this study were disappointing in that previous studies have shown a reduction in pain scores with remifentanil [11][12][13]. In this study we chose an averaged dose rather than a calculated weight-based dose, which might account for the difference.…”

Section: Discussionmentioning

confidence: 95%

See 1 more Smart Citation

Patient controlled analgesia for labour: a comparison of remifentanil with pethidine*

et al. 2004

View full text Add to dashboard Cite

SummaryWe compared the analgesic efficacy and safety of remifentanil and pethidine via patient controlled analgesia for women in established uncomplicated labour. Women received either remifentanil 40 lg with a 2-min lockout (n = 20) or pethidine 15 mg with a 10-min lockout (n = 19). Visual analogue scores for pain during the study and for overall pain were similar for both groups (mean (SD) 6.4 (1.5) cm for remifentanil and 6.9 (1.7) cm for pethidine). The area under the curve for visual analogue scores of satisfaction with analgesia was higher for remifentanil than for pethidine (p = 0.001). Maternal arterial oxygen saturation was similar in both groups. Neurologic and Adaptive Capacity Scores at 30 min were higher for remifentanil than for pethidine (median (interquartile range [range]) 36 (34.5-37 [32-39]) vs 34 (33-35 [30-35]), respectively; p = 0.003).

show abstract

Section: Discussionmentioning

confidence: 95%

“…The successful use of remifentanil for PCA in labour has been documented in several case reports [11,12]; we have investigated the efficacy and safety of PCA using remifentanil in a recent study [13] and demonstrated that bolus doses in the range 0.25-0.5 lg.kg…”

mentioning

confidence: 96%

Patient controlled analgesia for labour: a comparison of remifentanil with pethidine*

et al. 2004

View full text Add to dashboard Cite

show abstract

“…No se acumula y su metabolismo es independiente de la función renal o hepática 68 . Atraviesa la placenta con ratios vena umbilical / arteria materna de 0,73 y arteria umbilical / vena umbilical de 0,60 69 , pero se metaboliza o redistribuye rápidamente por el feto y no produce depresión neonatal [70][71][72] , en parte debido a que la vida media del remifentanilo en el feto es similar a la del adulto 73 . Sus características farmacocinéticas lo convierten en alternativa para administrar en PCA en pacientes con contraindicación para la analgesia neuroaxial 65,[74][75][76][77] , aunque se necesitan más estudios para valorar su eficacia y seguridad 78 .…”

Section: Opioidesunclassified

Técnicas analgésicas para el parto: alternativas en caso de fallo de la epidural

Ortiz-Gómez

Palacio-Abizanda

Fornet-Ruiz

2014

Anales Sis San Navarra

View full text Add to dashboard Cite

Se insiste en la necesidad de aplicar una aproximación terapéutica multifactorial a la embarazada, no limitándonos solo a eliminar el dolor del parto.Palabras clave: Analgesia obstétrica. Dolor del parto. Epidural. Analgesia controlada por el paciente. Remifentanilo. AbsTrAcTEpidural analgesia is now the method of choice for the treatment of pain in labour and delivery. However, this technique may fail and provide inadequate or null alleviation to the mother. This paper reviews the risk factors, possible causes and possible therapeutic alternatives to inadequate analgesia, whether pharmacological therapies (neuroaxial, peripheral blocks or analgesic administration via intravenous or inhalational routes) or non-pharmacological ones (relaxation techniques, psychological or mechanical).In all possible cases the efficacy and indications of alternative therapies based on the published literature are reviewed, especially from the point of view of evidence-based medicine.The need is underscored of a multifactorial therapeutic approach to the pregnant woman, not just restricting ourselves to eliminating the pain of childbirth.

show abstract

“…Kan et al (1998) studied the basic pharmacokinetics of remifentanil given as an adjunct to epidural anaesthesia for caesarean section. Remifentanil was introduced into obstetric analgesia shortly after this, which was reflected in the publication of the first case reports of effective IV remifentanil analgesia during labour (Brada et al 1998, Jones et al 1999, Thurlow & Waterhouse 2000, Roelants et al 2001.…”

Section: Remifentanilmentioning

confidence: 99%

Intravenous patient-controlled analgesia with remifentanil in early labour

Volmanen¹

2011

Acta Anaesthesiologica Scandinavica

View full text Add to dashboard Cite

Cover design Raimo Ahonen JUVENES PRINT TAMPERE 2010Volmanen, Petri, Intravenous patient controlled analgesia with remifentanil in early labour. AbstractIn four prospective clinical trials, 114 parturients used intravenous patient-controlled remifentanil analgesia during the 1 st stage of labour. The median effective dose per bolus was ascertained to be 0.4 μg/kg and the pain scores were reduced with this by a median of 2 on a numerical scale (0-10). Compared with nitrous oxide, 15 parturients included in a cross-over study reported a larger reduction in pain scores during remifentanil analgesia (1.5 vs. 0.5, p = 0.001) and better pain relief scores (2.5 vs. 0.5 on a ranked five point scale 0-4, p < 0.001). In a parallel study including 45 parturients, epidural analgesia (EDA, 20 ml bupivacaine 0.625 mg/ml and fentanyl 2 μg/ml) was associated with lower pain scores (5.2 vs. 7.3 with remifentanil, p = 0.004) but variables related to satisfaction with analgesia (pain relief score, proportion of mothers with desire to continue with the given medication and termination of the study due to inadequate pain relief) were similar. A comparison of two methods for timing the remifentanil bolus during the uterine contraction cycle suggested that delaying the bolus does not improve analgesia. A period effect was noted in the cross-over trial with higher pain scores and increased drug consumption during the second study period suggesting acute hyperalgesia.Side effects of remifentanil analgesia included respiratory depression warranting oxygen supplementation in 33% of parturients. Sedation was experienced by the parturients using remifentanil and this was scored as stronger than sedation during nitrous oxide and EDA. The number of parturients with nausea did not increase during remifentanil analgesia. Other maternal side effects included dizziness, a difficulty in visual focusing and itching. Foetal heart rate tracing abnormalities were noted. The incidence of abnormal tracings and decreased UapH were not different, however, from that observed during nitrous oxide or EDA. Apgar scores at 1 and 5 minute indicated no neonatal depression. Keywords

show abstract

Patient-Controlled Analgesia Using Remifentanil in the Parturient with Thrombocytopaenia

Cited by 20 publications

References 0 publications

Patient controlled analgesia for labour: a comparison of remifentanil with pethidine*

Patient controlled analgesia for labour: a comparison of remifentanil with pethidine*

Técnicas analgésicas para el parto: alternativas en caso de fallo de la epidural

Intravenous patient-controlled analgesia with remifentanil in early labour

Contact Info

Product

Resources

About