Remifentanil for labor analgesia: a comprehensive review.
Japan has seen significant developments in obstetric anesthesia in recent years, including the establishment of the Japanese Society of Obstetric Anesthesia and Perinatology. However, labor pain, which is one of the most important issues in obstetric practice, is still not treated aggressively. The rate of epidural administration for labor analgesia is very low in Japan as compared to other developed countries. Remifentanil has been used for labor analgesia, as part of general anesthesia for cesarean delivery, as well as for various fetal procedures around the world. Intravenous patient-controlled analgesia (IVPCA) with remifentanil is considered to be a reasonable option for labor pain relief. Several studies have demonstrated its efficacy with minimal maternal and neonatal adverse effects. On the other hand, reports of cases of maternal cardiac and respiratory arrest with remifentanil IVPCA within the past couple of years have redirected our attention to its safe use. Remifentanil IVPCA warrants one-to-one nursing monitoring, appropriate education of healthcare providers, continuous maternal oxygen saturation monitoring, end-tidal CO2monitoring, and availability of both maternal and neonatal resuscitation equipment. This article provides an overview of knowledge and principles of using remifentanil IVPCA for labor analgesia and introduces its potential usage in Japan.
Department of Anaesthesia, Fremantle Hospital and Health Service, Alma Street, Fremantle, WA, 6160, Australia. Yayoi.Ohashi@health.wa.gov.au.
Yayoi
Y
Ohashi
Department of Anesthesiology, South Health Campus, University of Calgary, Calgary, Canada.
Leyla
L
Baghirzada
Department of Anesthesiology, Juntendo University, Tokyo, Japan.
Hiroyuki
H
Sumikura
Department of Anesthesia and Pain Management, Mount Sinai Hospital, University of Toronto, Toronto, Canada.
Mrinalini
M
Balki
D015360:Analgesia, Epidural / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000379:methods*; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007564:Japan; D048949:Labor Pain / Q000188:drug therapy; D010880:Piperidines / Q000008:administration & dosage*; D011247:Pregnancy; D000077208:Remifentanil
D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil
Labor analgesia; Obstetric anesthesia; Remifentanil