title: Patient-controlled intravenous analgesia remifentanil for labor analgesia: time to stop, think and reconsider.
abstract: OBJECTIVE
  Remifentanil is a relatively new but commonly used opioid alternative in the management of labor pain relief. The present article evaluates efficacy and safety of patient-controlled intravenous analgesia (PCIA) with remifentanil in the management of labor pain relief.
  
  
  RESULTS
  Remifentanil PCIA provides analgesia that is superior to nitrous oxide or other opioids such as meperidine, but is less effective when compared with epidural analgesia. Recent evidence suggests it produces significant respiratory depression making routine use as first line analgesia strategy virtually impossible.
  
  
  CONCLUSIONS
  Remifentanil PCIA is a valuable analgesic strategy whenever regional analgesia is contraindicated. Using it as first line strategy seems to be contraindicated because of significant respiratory side-effects to the mother. Whenever used advanced and continuous monitoring using capnography, saturation monitoring and one-to-one midwifery care are mandatory!
authors.affiliation: aDepartment of Cardiovascular Sciences bDepartment of Anesthesiology, UZ Leuven, Leuven, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Van de Velde
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D016362:Analgesia, Obstetrical / Q000379:methods*; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D005260:Female; D006801:Humans; D010880:Piperidines / Q000008:administration & dosage; D011247:Pregnancy; D000077208:Remifentanil
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil