Remifentanil at a Relatively Elevated Dose in Active Phase is Safe and More Suitable Than Fixed Lower Dose for Intravenous Labor Analgesia

作者全名："Cai, Meng; Liu, Jie; Lei, Xiao-Feng; Li, Yun-Long; Yu, Jin"

作者地址："[Cai, Meng; Lei, Xiao-Feng; Yu, Jin] Chongqing Med Univ, Women & Childrens Hosp, Chongqing Hlth Ctr Women & Children, Dept Anesthesiol, 120 Longshan Rd, Chongqing 401147, Peoples R China; [Liu, Jie] Chongqing Med Univ, Affiliated Banan Hosp, Peoples Hosp Chongqing Banan Dist, Dept Resp, Chongqing, Peoples R China; [Li, Yun-Long] Chongqing Med Univ, Women & Childrens Hosp, Chongqing Hlth Ctr Women & Children, Dept Obstet & Gynecol, Chongqing, Peoples R China"

通信作者："Yu, J (通讯作者)，Chongqing Med Univ, Women & Childrens Hosp, Chongqing Hlth Ctr Women & Children, Dept Anesthesiol, 120 Longshan Rd, Chongqing 401147, Peoples R China."

来源：JOURNAL OF PAIN RESEARCH

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:001038228500001

JCR分区：Q2

影响因子：2.5

年份：2023

卷号：16

期号：　

开始页：2543

结束页：2552

文献类型：Article

关键词：patient-controlled analgesia; PCA; remifentanil; labor analgesia; intravenous administration; opioids

摘要："Background: Intravenous labor analgesia is recommended as an alternative for parturients who have contraindications to epidural analgesia. There are several opioid analgesics and different administering regimens used in the clinic. This study aimed to compare the effectiveness and safety of two intravenous remifentanil dosage regimens in the first labor stage. Patients and Methods: One hundred and fifteen parturients with a contraindication to epidural analgesia but were willing to receive systemic labor analgesia were randomized into group A received a fixed dose of remifentanil throughout the first stage of labor, and group B received an elevated dose of remifentanil during the active phase of the first stage both by patient-controlled analgesia (PCA). Maternal numerical rating scale (NRS) pain score and oxygen desaturation, sedation efficacy, satisfaction, as well as maternal and fetal adverse reactions were recorded and compared. Results: The mean NRS pain scores before analgesia and in the latent phase showed no statistically significant difference between the two groups (P > 0.05). However, during the active phase, group B demonstrated significantly lower mean NRS pain scores and lowest pain score compared to group A (P < 0.05). Furthermore, group B exhibited higher overall sedation scores and satisfaction scores in comparison to group A (P < 0.05). The incidence of adverse reactions between the two groups was similar (P > 0.05). Conclusion: Relatively elevated intravenous dosage of remifentanil with PCA during the active phase in the first stage of labor is safe and more effective than a fixed-dosage regimen for labor analgesia."

基金机构：Chongqing Maternal and Child Health Scientific Research and Cultivation Project [2021FY106]; Natural Science Foundation of Chongqing of China [cstc2021jcyj-msxmX0763]; National Key Clinical Speciality Construction Project (Obstetrics and Gynecology)

基金资助正文："Funding This study was supported by Chongqing Maternal and Child Health Scientific Research and Cultivation Project (No. 2021FY106) , Natural Science Foundation of Chongqing of China (No. cstc2021jcyj-msxmX0763) and National Key Clinical Speciality Construction Project (Obstetrics and Gynecology) ."