title: A Survey of Intravenous Remifentanil Use for Labor Analgesia at Academic Medical Centers in the United States.
abstract: Remifentanil is most commonly offered when neuraxial labor analgesia is contraindicated. There is no consensus regarding the optimal administration, dosing strategy, or requirements for maternal monitoring, which may pose a patient safety issue. This exploratory survey evaluated the current practices regarding remifentanil use for labor analgesia at academic centers in the United States. Of 126 obstetric anesthesia directors surveyed, 84 (67%) responded. In 2014 to 2015, an estimated 36% (95% confidence interval: 25.7-46.3) of centers used remifentanil, most of which did so less than 5 times. Some serious maternal and neonatal respiratory complications occurred, emphasizing that clinical protocols and adequate monitoring are key to ensure maternal and neonatal safety.
authors.affiliation: From the *Department of Anesthesiology, Weill Cornell Medicine, New York, New York; and †Department of Anesthesiology, Columbia University Medical Center, New York, New York.
authors.forename: Jaime
authors.initials: J
authors.lastname: Aaronson
authors.forename: Sharon
authors.initials: S
authors.lastname: Abramovitz
authors.forename: Richard
authors.initials: R
authors.lastname: Smiley
authors.forename: Virginia
authors.initials: V
authors.lastname: Tangel
authors.forename: Ruth
authors.initials: R
authors.lastname: Landau
mesh_terms: D000046:Academic Medical Centers / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000009:adverse effects / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D010880:Piperidines / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy; D000077208:Remifentanil; D012131:Respiratory Insufficiency / Q000139:chemically induced; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil