Remifentanil infusion as an adjunct to epidural anaesthesia for caesarean section

Abstract

Introduction: A degree of intraoperative pain occurs in up to 50% of patients during caesarean section under epidural anaesthesia using 0.5% bupivacaine alone.t Expectations for pain-free surgery are high, leading to patient dissatisfaction and consequent medicolegal implications. The addition of epidural opioid improves the quality of epidural anaesthesia, yet up to 42% of women require additional intraoperative analgesia. 2 Intravenous remifentanil has been widely used in awake patients to supplement regional anaesthesia. 3 A low-dose remifentanil infusion may reduce discomfort during epidural caesarean section without causing significant adverse effects to mother or baby.