Clinical study on the effect of remifentanil patient-controlled intravenous labor analgesia compared to patient-controlled epidural labor analgesia.

Abstract

This study aims to investigate the safety and efficacy of remifentanil for patient-controlled intravenous labor analgesia as an alternative to the patient-controlled epidural labor analgesia. METHODS: Out of 453 parturients who volunteered for labor analgesia and were selected as research objects, 407 completed the trial. They were divided into the research group (n = 148) and the control group (n = 259; patient-controlled epidural analgesia). In the research group, the first dose of remifentanil, the background dose and the patient-controlled analgesia (PCA) dose were 0.4 μg/kg, 0.04 μg/min and 0.4 μg/kg, respectively, with a lockout interval of 3 min. The control group was given epidural analgesia. The first dose and background dose were 6-8 mL, and PCA dose and the locking time of analgesia pump were 5 mL and 20 min, respectively. The following indexes of the two groups were observed and recorded: the analgesic and sedative effects on parturient, labor process, forceps delivery, cesarean section rate and adverse reactions, and maternal and neonatal conditions. 1. The onset time of analgesia in the research group was (0.97 ± 0.08) min, which was noticeably shorter than that in the control group ([15.74 ± 1.91] min), with a statistically significant difference (t = -93.979, p = 0.000). 2. There was no significant difference in the labor process, forceps delivery, cesarean section rate and neonatal condition between the two groups (p > 0.05). Remifentanil patient-controlled intravenous labor analgesia has the advantage of rapid onset of labor analgesia. Although its analgesic effect is not as accurate and stable as epidural patient-controlled labor analgesia, it shows a high level of maternal and family satisfaction.