Mode and dosage of patient-controlled intravenous labor analgesia with remifentanil during natural delivery

Objective To discuss the mode and dosage of patient-controlled intravenous labor analgesia with remifentanil during natural delivery.Methods Sixty natural childbirth primiparas were randomly divided into 3 groups with 20 cases each.At the same time of doula delivery,PCIA in group A was performed with a single dose of remifentanil 0.25 μg/kg and lockout period of 3 min.The patients in group B were given additional infusion of remifentanil 0.025 μg·kg-1·min-1.The patients in group C were treated in a conventional way of analgesia.The indexes of sedation and analgesia,labor course and Apgar score of neonatus were compared.Results The effects of sedation and analgesia of group B were the best among three groups.Visual analogue score(VAS) was(3.4±0.9) points in group B,which was significantly lower than(6.4±1.0) points of group A or(8.2±1.5) points of groupC(P0.05).The incidence of respiratory depression in group B was similar to that in group A(12.7% vs.10.2%)(P0.05).There were no significant differences in the indexes of uterine contraction,fetal heart rate,Apgar score of neonates,the time of each delivery paragraph,blood loss,oxytocin application and the rate of apparatus delivery and Cesarean section among three groups.Conclusion At the same time of doula delivery,PCIA with infusion of remifentanil 0.025 μg·kg-1·min-1 and bolus remifentanil 0.25 μg/kg in a lockout period of 3 min is a better mode for labor analgesia.