[Intravenous remifentanyl for labor analgesia].
BACKGROUND
Intravenous remifentanil may be the preferred analgesic when regional techniques are contraindicated.


OBJECTIVE
To perform a systematic review on the use of remifentanil for analgesia in labor.


METHODS
We searched MEDLINE (January 1995-August 2007) for studies on obstetric analgesia with remifentanil.


RESULTS
We found 32 references representing the use of remifentanil in 257 women in labor. In most cases, patients reported relief of pain and a high level of satisfaction, with no severe side effects in mothers or neonates. When compared with meperidine and nitrous oxide in clinical trials, remifentanil provided better analgesia with fewer adverse effects.


CONCLUSIONS
Analgesia with intravenous remifentanil is more effective and safer than other alternatives to regional analgesic techniques in obstetrics. Nevertheless, the optimum system for infusing the drug must b e established and further studies of maternal and fetal safety should be carried out.
Arnal
D
D
Unidad de Anestesia y Reanimación, Fundación Hospital Alcorcón, Alcorcón, Madrid. darnal@fhalcorcon.es
Serrano
M L
ML
Corral
E M
EM
García del Valle
S
S
D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D001034:Apgar Score; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D005260:Female; D005333:Fetus / Q000187:drug effects; D006801:Humans; D000860:Hypoxia / Q000139:chemically induced / Q000517:prevention & control / Q000628:therapy; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D008614:Meperidine / Q000008:administration & dosage / Q000009:adverse effects; D009609:Nitrous Oxide / Q000008:administration & dosage / Q000009:adverse effects; D010102:Oxygen Inhalation Therapy; D010342:Patient Acceptance of Health Care; D010880:Piperidines / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy; D011446:Prospective Studies; D000077208:Remifentanil
D000700:Analgesics; D000701:Analgesics, Opioid; D010880:Piperidines; D008614:Meperidine; D009609:Nitrous Oxide; D000077208:Remifentanil