Patient-controlled intravenous analgesia with remifentanil in labor

Objective:To assess the safety and feasibility of remifentanil in patient-controlled intravenous analgesia(PCIA) during labor.Methods:65 full-term pregnant women were randomized to three groups at active phase.Group A received PCIA with remifentanil by electronic pump.There was 0.5 μg·kg-1 bolus and 3 min lock-out time while uterus constrictions coming until cervix completely opened.Group B received 0.05 μg·kg-1·min-1 remifentanil as background infusion,besides the same treatment as group A.Group C didn't use medicine to ease the pain.Visual analogue score(VAS),Ramsay score(RSS),mean blood pressure(MAP),heart rate(HR),saturation of blood pulse oxygen,respiratory rate(RR) were recorded.And the change of uterus constrictions and fetus heart rate,the Apgar score,oxytocin and obstetric forceps' application,ratio of cesarean section,and side effects were also observed.Results:VAS was lower in group A and B than that of group C since 20 min after analgesia(P0.01).The satisfaction rate of analgesia in group A was 17/21,while 21/21 in group B,and 0/23 in group C.The force of labor were same in the middle of three groups(P0.05).The administer time in group B(50) were less than in group A(78) (P0.01). Used quantity of remifentanil and VAS in group A and B were the same.The oxytocin and obstetric forceps' application,ratio of cesarean section had no difference in statistics(P0.05).There was no depression to fetus and no over-sedation or hypoxemia to lying-in women with low-flown oxygen given by nasal catheter.Conclusion:Remifentanil with the mode of PCIA can ease labor pain effectively and safely.Additional background infusion will decrease the frequency of manipulation.