Effect of remifentanil and oxycodone on intravenous labor analgesia

Abstract

Objective To compare the efficacy of intravenous labor analgesia with remifentanil and remifentanil/oxycodone and its influence on maternal and neonatal. Methods A total of 90 cases of term parturient in active stage of childbirth with a single fetus and ASA I to II were randomly divided into three groups (R group, remifentanil group, Q group, remifentanil/oxycodone group and C group, CSEA group), with 30 cases in each group. The maternal in R group were connected with the intravenous analgesic pump with remifentanil 20 μg/ml. The background dose was set to 0.01 - 0.05 μg /(kg·min), the bolus dose was 0.4 μg/kg and thelock time was 5 min. In Q group, the maternal were connected with the same intravenous analgesic pump as in R group, and received intravenousdrip 2 - 10 mg oxycodone as first dose within 1 - 2 minutes in addition. Then the first dose we repeated after 3 - 4 h. In C group, the maternal were administrated with sufentanil 5 μg intrathecal , and then epiduralanesthesiapump with 0.08% ropivacaine and sufentanil 0.45 μg/ml.The maternal mean arterial pressure(MAP), heartrate(HR), respiratory(RR), pulsebloodoxygensaturation(SPO2), numerical rating scale(NRS)score, Ramsay score, 1 min, 5 min Apgar scores after birth, neonatal blood gas analysis on umbilical artery in three groups were recorded. Results The NRS score in R group was 3 - 4. Compared with C group, the difference was significant (P 0.05). The NRS score in Q group was 2 on average. There was significant difference compared with R group(P 0.05). Conclusions Both intravenous analgesia with remifentanil or remifentanil/oxycodone can provide effective analgesia. Remifentanil/oxycodone can provide more effective and comfortable labor analgesia. All the three analgesia methods do not increase the adverse reaction on maternal and neonatal in birth ingperiod. Key words: Remifentanil; Oxycodone; Intravenous labor analgesia