Remifentanil for labor analgesia: a comprehensive review

详细信息    查看全文

• 作者：Yayoi Ohashi ; Leyla Baghirzada ; Hiroyuki Sumikura ; Mrinalini Balki
• 关键词：Remifentanil ; Obstetric anesthesia ; Labor analgesia
• 刊名：Journal of Anesthesia
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：30
• 期：6
• 页码：1020-1030
• 全文大小：447 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Anesthesiology
  
• 出版者：Springer Japan
• ISSN：1438-8359
• 卷排序：30

文摘

Japan has seen significant developments in obstetric anesthesia in recent years, including the establishment of the Japanese Society of Obstetric Anesthesia and Perinatology. However, labor pain, which is one of the most important issues in obstetric practice, is still not treated aggressively. The rate of epidural administration for labor analgesia is very low in Japan as compared to other developed countries. Remifentanil has been used for labor analgesia, as part of general anesthesia for cesarean delivery, as well as for various fetal procedures around the world. Intravenous patient-controlled analgesia (IVPCA) with remifentanil is considered to be a reasonable option for labor pain relief. Several studies have demonstrated its efficacy with minimal maternal and neonatal adverse effects. On the other hand, reports of cases of maternal cardiac and respiratory arrest with remifentanil IVPCA within the past couple of years have redirected our attention to its safe use. Remifentanil IVPCA warrants one-to-one nursing monitoring, appropriate education of healthcare providers, continuous maternal oxygen saturation monitoring, end-tidal CO₂ monitoring, and availability of both maternal and neonatal resuscitation equipment. This article provides an overview of knowledge and principles of using remifentanil IVPCA for labor analgesia and introduces its potential usage in Japan.