Options for systemic labor analgesia

Research output: Contribution to journalReview articlepeer-review

Abstract

PURPOSE OF REVIEW: This article reviews the challenging practice of systemic analgesia as an alternative to epidural analgesia for labor pain, and places remifentanil within the context of opioid analgesics suitable for managing for labor pain. RECENT FINDINGS: Although systemic opioids have long been used for labor analgesia, they have become less popular because of frequent maternal and neonatal side effects. Recently, their efficacy has been questioned. Patient-controlled intravenous analgesia with fentanyl or sufentanil is currently the method of choice for achieving analgesia during early labor, when epidural analgesia is not feasible. Remifentanil has been suggested as the opioid of choice for labor analgesia, having the advantage of easy administration, predictable pharmacokinetics, and improved neonatal outcomes. The position of remifentanil in obstetric analgesia is now better understood, as reflected by the increasing number of reported studies describing its use. SUMMARY: Remifentanil is now gaining popularity. Remifentanil may be more suitable than other traditional opioids for inducing labor analgesia. Careful monitoring of the parturient and the newborn is recommended, however, to mitigate the potential for maternal and neonatal hypoxemia.

Original languageEnglish
Pages (from-to)181-185
Number of pages5
JournalCurrent Opinion in Anaesthesiology
Volume20
Issue number3
DOIs
StatePublished - Jun 2007

Keywords

  • Labor analgesia
  • Remifentanil
  • Systemic opioids

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