title: The Comparison of Patient-Controlled Remifentanil Administered by Two Different Protocols (Bolus and Bolus+Infusion) and Intramuscular Meperidine for Labor Analgesia.
abstract: OBJECTIVE
  Nowadays, there are many pain relief methods for reducing the pain and stress of labor and delivery. In our study, two different remifentanil protocols (bolus and bolus+infusion) administered by patient-controlled analgesia method were compared with intramuscular meperidine for labor analgesia.
  
  
  METHODS
  Ninety parturients who were scheduled for vaginal delivery were included in this study. Patients were randomly divided into 3 groups, with 15 primiparous and 15 multiparous patients in each group. Whenever a patient requested analgesics during the labor, Group M was given 1 mg kg(-1) intramuscular meperidine, Group B was given intravenous bolus patient-controlled remifentanil, and Group IB was given intravenous bolus+infusion patient-controlled remifentanil. Patients' systolic and diastolic blood pressure, heart rate, pain-comfort and sedation scores, remifentanil consumption, side effects, and Apgar scores of the newborns were evaluated during the labor and delivery.
  
  
  RESULTS
  Patients' mean pain and comfort scores were significantly lower in Groups B and IB than in Group M at all time intervals except the first minute. Compared with Group IB, mean pain and comfort scores at 15, 30, 60, and 120 minutes were significantly higher in Group B. The mean sedation scores were similar among the groups. Total remifentanil consumption was lower in Group IB than in Group B, but it was not statistically significant.
  
  
  CONCLUSIONS
  Patient-controlled intravenous bolus or bolus+infusion remifentanil provided more effective analgesia and patient comfort than intramuscular meperidine for labor analgesia. Especially during labor, bolus+infusion remifentanil administration provided better pain and patient comfort scores than bolus alone, without increasing remifentanil consumption.
authors.affiliation: Clinic of Anaesthesiology, Private Tarsus Medical Park Hospital, Mersin, Turkey.
authors.forename: Süleyman
authors.initials: S
authors.lastname: Güneş
authors.affiliation: Department of Anaesthesiology, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Mediha
authors.initials: M
authors.lastname: Türktan
authors.affiliation: Department of Obstetrics and Gynaecology, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Ümran Küçükgöz
authors.initials: ÜK
authors.lastname: Güleç
authors.affiliation: Department of Anaesthesiology, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Zehra
authors.initials: Z
authors.lastname: Hatipoğlu
authors.affiliation: Department of Anaesthesiology, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Hakkı
authors.initials: H
authors.lastname: Ünlügenç
authors.affiliation: Department of Anaesthesiology, Çukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Geylan
authors.initials: G
authors.lastname: Işık
keywords: Labor analgesia; meperidine; patient-controlled analgesia; remifentanil