Case Series of Vital Signs-controlled, Patient-assisted Intravenous Analgesia (VPIA) Using Remifentanil for Labor and Delivery. Issue 1 (March 2018)

• Record Type: Journal Article
• Authors: Leong, W.L.; Sng, B.L.; Zhang, Q.; Han, N.L.R.; Sultana, R.; Sia, A.T.H.
• Is Part Of: Obstetric anesthesia digest. Volume 38:Issue 1(2018)
• Publication Date: 2018-03
• Subjects: Analgesia for Labor -- Pharmacology; Anesthesia in obstetrics -- Periodicals; Anesthesia in obstetrics -- Abstracts -- Periodicals; 617.968205
• DOI: 10.1097/01.aoa.0000530013.06592.65
• Languages: English
• ISSNs: 0275-665X

Abstract

Abstract : ( Anaesthesia . 2017;72(7):845–852) Intravenous remifentanil patient-controlled analgesia (PCA) is an alternative to epidural analgesia for labor pain management. Compared with other systemic opioids, its unique pharmacokinetic properties make it a preferred alternate analgesic. These properties included fast onset, an ultra-short context-sensitive half-life, and rapid redistribution and elimination by the fetus. Remifentanil is known, however, to cause maternal respiratory depression when used for labor analgesia. This leads to maternal oxygen desaturation in a significant proportion of women, although it is generally short-lived. Rarely respiratory arrest has been reported. It is thus strongly recommended that when administering remifentanil PCA, maternal respiratory rate and oxygen saturation be continuously monitored.