[3 cases of sedation and analgesia using propofol and remifentanil for labor].
Three women in labor for whom epidural analgesia was contraindicated--2 with sepsis (pylonephritis and chorioamnionitis) and 1 with sacral agenesia--were provided intravenous analgesia with propofol (0.4-1.2 mg/kg/h) and remifentanil (0.033-0.1 microgram/kg/min plus boluses of 20 micrograms controlled by the patient) with oxygen supplementation. Heart rate, noninvasive blood pressure, maternal oxygen saturation and fetal heart rate were monitored. Maternal satisfaction, quality of analgesia, maternal side effects (sedation, depression, breathing, muscle rigidity, nausea, and vomiting) and fetal side effects (heart rate variability and Apgar score) were evaluated. We conclude that in cases where epidural analgesia is contraindicated, intravenous perfusion of low doses of propofol and remifentanil can provide a valid alternative for analgesia during labor.
Fontao Rodríguez
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Departamento de Anestesiología, Reanimación y Terapéutica del Dolor, Institut Universitari Dexeus, C/Calatrava no 83, 08017 Barcelona.
D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D001034:Apgar Score; D000075202:Contraindications; D005260:Female; D005333:Fetus / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D017060:Patient Satisfaction; D010880:Piperidines / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications; D015742:Propofol / Q000008:administration & dosage / Q000627:therapeutic use*; D000077208:Remifentanil
D000700:Analgesics; D006993:Hypnotics and Sedatives; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol