“Do no harm” - Where to place remifentanil for labour analgesia?

Melber, Andrea; Sia, Alex Tiong Heng

doi:10.1016/j.tacc.2017.10.065

Cited by 10 publications

(7 citation statements)

References 62 publications

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“…Serious adverse events attributed to remifentanil patient-controlled analgesia during labour in The Netherlands. International Journal of obstetric Anesthesia: 2019, 3, p. [22][23][24][25][26][27][28] Although, according to the Dutch SOP, one-to-one care is not mandatory after the first hour of remifentanil administration, it is likely that continuous one-to-one care prevents apnoea. A balance between strict maternal monitoring and feasibility for healthcare providers is needed when remifentanil is used for labour analgesia.…”

Section: Discussionmentioning

confidence: 99%

“…Serious adverse events attributed to remifentanil patient-controlled analgesia during labour in The Netherlands. International Journal of obstetric Anesthesia: 2019, 3, p. [22][23][24][25][26][27][28] The Dutch SOP prescribes requirements for the use of remifentanil PCA, such as education for healthcare providers, the procedure to obtain informed consent, maternal monitoring requirements, preparation for the application of the method, treatment for complications and documentation. Since the literature does not provide an operational definition of an SAE related to remifentanil use, we established our two expert teams.…”

Section: Methodsmentioning

confidence: 99%

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Serious adverse events attributed to remifentanil patient-controlled analgesia during labour in The Netherlands

Logtenberg

Vink²,

Godfried

et al. 2019

International Journal of Obstetric Anesthesia

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Background: During labour, remifentanil patient-controlled analgesia is used as an alternative to neuraxial analgesia. Remifentanil is associated with hypoventilation and respiratory depression but the frequency of serious maternal and neonatal adverse events is unknown. The aim of this study was to estimate the number of serious adverse events attributed to the use of remifentanil patient-controlled analgesia during labour in The Netherlands and to investigate the circumstances (e.g. monitoring, practice deviations) of these events and the subsequent management. Methods: In a nationwide survey among obstetricians, anaesthetists and clinical midwives the frequency of serious adverse events was assessed. A questionnaire was sent by email to

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Section: Discussionmentioning

confidence: 99%

“…Serious adverse events attributed to remifentanil patient-controlled analgesia during labour in The Netherlands. International Journal of obstetric Anesthesia: 2019, 3, p. [22][23][24][25][26][27][28] The Dutch SOP prescribes requirements for the use of remifentanil PCA, such as education for healthcare providers, the procedure to obtain informed consent, maternal monitoring requirements, preparation for the application of the method, treatment for complications and documentation. Since the literature does not provide an operational definition of an SAE related to remifentanil use, we established our two expert teams.…”

Section: Methodsmentioning

confidence: 99%

Serious adverse events attributed to remifentanil patient-controlled analgesia during labour in The Netherlands

Logtenberg

Vink²,

Godfried

et al. 2019

International Journal of Obstetric Anesthesia

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“…So far, research into remifentanil PCA has concentrated on efficacy, satisfaction and side‐effects . Today, there is evidence that pain relief with remifentanil PCA is effective; less effective than neuraxial analgesia, but more effective than long‐acting opioids or nitrous oxide . In view of the high maternal satisfaction rate of the remifentanil group in Wilson et al's study , complete labour pain relief may not be the ultimate goal.…”

Section: Confusing Recommendationsmentioning

confidence: 99%

Remifentanil patient‐controlled analgesia (PCA) in labour – in the eye of the storm

Melber

2018

Anaesthesia

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“…Until this time comes, our duty is to pursue patients' safety and satisfaction, and to provide, as from excellent research from Melber and Coworkers [7], the search of the perfect painless labour. A search which is part of our nature, as from same Dante Alighieri's words:…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

“…In the December issue of Trends in Anaesthesia and Critical Care [7], Andrea Melber and Alex Sia, explore efficacy, safety and risks of remifentanil Patient-Controlled intravenous Analgesia (PCA) for labour in relation to the other better established pharmacological methods. We want to thank the authors to point out some worthy-of-support statements and to provide us with the opportunity to make a point.…”

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confidence: 99%

The painful search of a painless labour

Micaglio

Sorbello

Filippo

2018

Trends in Anaesthesia and Critical Care

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During the 12th and 13th centuries, rivalry between "The Guelphs" and "The Ghibellines" (factions supporting the Church and the Holy Roman Empire, respectively) characterized a particularly intense aspect of the internal politics in the city-states of central and northern Italy, particularly in Tuscany. The Guelph-Ghibelline conflict, which was described also in Dante's Divina Comedia, gave way to an especially ferocious and painful civil war lasted for decades, and ending without a real winner [1]. In 2000, a preliminary investigation on remifentanil as a systemic drug for obstetric analgesia concluded that remifentanil was "unsuitable during labour" [2]. Months later (2001) a prospective study on the same topic stated that it had the properties of an "ideal systemic analgesic for use during labour" [3]. Since then something like 160 articles evaluating the use of intravenous remifentanil for labour analgesia, resulted in mixed findings regarding its safety and efficacy in attenuating labour pain if compared with other opioids or neuraxial techniques. Some strong statements were in favor of remifentanil "… it is an important advance in the obstetric anesthesia armamentarium for parturients who do not want neuraxial analgesia" [4]. While some others were against it: "…

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“Do no harm” - Where to place remifentanil for labour analgesia?

Cited by 10 publications

References 62 publications

Serious adverse events attributed to remifentanil patient-controlled analgesia during labour in The Netherlands

Serious adverse events attributed to remifentanil patient-controlled analgesia during labour in The Netherlands

Remifentanil patient‐controlled analgesia (PCA) in labour – in the eye of the storm

The painful search of a painless labour

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