[French national survey on remifentanil utilisation for obstetrical peridural analgesia].
OBJECTIVE
The last French survey on alternatives to neuraxial anaesthesia for labour pain was published in 1997. However, intravenous remifentanil has become increasingly used as an option for labour analgesia. We evaluated the use of remifentanil as an alternative to epidural analgesia in level 2 and 3 French maternities in 2009.


METHODS
This was an internet-based French survey performed in 2009 including all level 2 and 3 maternities. Data recorded were maternity unit characteristic, alternatives to neuraxial analgesia used, and remifentanil administration protocols.


RESULTS
Two hundred and forty maternity units received the survey and 103 responses were completed. A written institutional alternative analgesia protocol for labour pain was present in 78%. Alternative labour analgesia included intermittent nitrous oxide inhalation (58%), intravenous nalbuphine (52%), patient-controlled intravenous administration of remifentanil (52%) and sufentanil (46%). Pethidine administration was reported by one maternity unit (1%). The bolus dose of remifentanil scheduled, and background infusion varied widely between maternity units. The analgesic efficacy of remifentanil used for labour pain was evaluated as moderate (55%) or good (43%). Two serious adverse events were reported.


CONCLUSIONS
Intravenous administration of remifentanil was largely reported as an alternative to neuraxial anaesthesia for labour pain. Although remifentanil administration was most often based on a local written protocol, bolus dose and background infusion varied widely between maternity units.
Pôle anesthésie-réanimation, samu hémovigilance coordination des prélèvements, centre hospitalier universitaire de Caen, avenue Côte-de-Nacre, 14033 Caen cedex, France. hanouz-jl@chu-caen.fr
J-L
JL
Hanouz
T
T
Simonet
C
C
Marliot
A
A
Mayaud
A
A
Girard
N
N
Rakotnirina
J-L
JL
Fellahi
J-L
JL
Gérard
D000328:Adult; D000767:Anesthesia, Epidural / Q000706:statistics & numerical data*; D000773:Anesthesia, Obstetrical / Q000706:statistics & numerical data*; D018686:Anesthetics, Intravenous; D004363:Drug Utilization; D005260:Female; D005602:France; D005843:Geography; D019538:Health Care Surveys; D006757:Hospital Units / Q000706:statistics & numerical data; D006801:Humans; D010880:Piperidines; D011247:Pregnancy; D000077208:Remifentanil; D011795:Surveys and Questionnaires
D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil