Remifentanil versus fentanyl for intravenous patient-controlled labour analgesia: an observational study.

摘要: We undertook a retrospective study to compare the analgesic efficacy and effects on neonatal outcome of administering either remifentanil or fentanyl intravenous patient-controlled analgesia (IVPCA) during labour. A five-year cohort was undertaken women with more than 24 weeks gestation who had received IVPCA for labour at Mount Sinai Hospital. The sampling timeframe from November 2005 March 2010. standard regimen group consisted PCA bolus 0.25 μg·kg−1 lockout interval two minutes, four-hour limit 3 mg, background infusion 0.025-0.05 μg·kg−1·min−1, whereas 25-50 μg three six minutes 1-1.5 mg. following data were compared: maternal hourly pain scores (verbal score scale 0-10), sedation (scale 0-3), adverse effects, outcomes. Mixed linear modelling used analyze longitudinal over time. exact Wilcoxon test Fisher’s other comparisons. Ninety-eight studied. There no significant difference in model-adjusted between groups (P = 0.86). moderate decrease both compared baseline values. side groups, although transient oxygen desaturation observed frequently (13% vs 2%, respectively; odds ratio, 7.32; 95% confidence [CI], 0.85 63.3). larger number neonates required resuscitation (59% 25%, 4.33; CI, 1.75 10.76); adjusted (44% 8%, 8.56; 2.17 33.77). Intravenous provides degree analgesia, is commonly remifentanil. Fentanyl associated higher need resuscitation.