Increased pain relief with remifentanil does not improve the success rate of external cephalic version: a randomized controlled trial

Burgos, Jorge; Pijoán, José Ignacio; Osuna, Carmen; Cobos, Patricia; Rodríguez, Laura Tesouro; Centeno, María del Mar; Serna, Rosa; Jiménez, Antonia Brox; Garcia, Eugenia; Fernández-Llebrez, Luis; Melchor, Juan Carlos

doi:10.1111/aogs.12859

Cited by 14 publications

(12 citation statements)

References 28 publications

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“…These findings are consistent with other studies that have shown that remifentanil could reduce pain and increase maternal satisfaction. [13,14] However, our study found that remifentanil could also improve the success rate for ECV.…”

Section: Discussionmentioning

confidence: 67%

“…[13,14] One randomized controlled trial found no difference in the success rate for ECV between patients who received remifentanil with paracetamol and subjects who received placebo with paracetamol. [13] However, the mean pain score was significantly lower in the remifentanil group than in the control group.…”

Section: Discussionmentioning

confidence: 99%

“…[13] Another randomized controlled trial also concluded that remifentanil analgesia decreased ECV-related pain, but failed to increase the success rate for ECV at term, and appeared to be associated with an increased frequency of mild AEs. [14] …”

Section: Discussionmentioning

confidence: 99%

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A randomized trial of remifentanil for analgesia in external cephalic version for breech presentation

Liu¹,

Xue

2016

Medicine

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Background:Although external cephalic version (ECV) can be effective for correcting the fetus in a cephalic presentation, it may be painful for the mother. This study aimed to evaluate the efficacy and safety of remifentanil for pain relief during ECV in China.Methods:In all, 152 Chinese parturients with singleton breech presentation were randomly divided into 2 groups, each with 76 patients. All 152 patients were assigned to receive either remifentanil (infused at 0.1 μg/kg/min and demand boluses of 0.1 μg/kg) or saline placebo. The study was performed between January 2012 and December 2015. Outcome measurements included the Numerical Rating Pain Scale score (0–10) after ECV, success rate for ECV, and maternal satisfaction after ECV. Adverse events were also evaluated.Results:The study was completed by 146 patients. Remifentanil showed greater efficacy than placebo in decreasing the pain score immediately after ECV (remifentanil 4.6 ± 2.6 vs placebo 6.5 ± 2.7; P < 0.001). The success rate for ECV showed a significant difference between the 2 groups (remifentanil 56.5% vs placebo 39.5%; P = 0.04). Maternal satisfaction also showed a significant difference between the 2 groups (remifentanil 9.6 ± 1.4 vs placebo 6.4 ± 3.7; P < 0.001). However, the adverse events profiles were similar between both groups.Conclusion:The results of this study demonstrate that remifentanil is an effective intervention for reducing pain, achieving successful ECV, and increasing maternal satisfaction during ECV, and is generally well-tolerated without additional adverse effects.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

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A randomized trial of remifentanil for analgesia in external cephalic version for breech presentation

Liu¹,

Xue

2016

Medicine

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“…These findings are consistent with those of other studies showing that remifentanil could reduce pain and increase maternal satisfaction. [15,17,18] In addition, analgesia with remifentanil could also improve the success rate of ECV. [15] …”

Section: Discussionmentioning

confidence: 99%

“…Thus, it does not have a cumulative effect and is therefore safely used for analgesia in obstetrics. [15] …”

Section: Introductionmentioning

confidence: 99%

Remifentanil analgesia during external cephalic version for breech presentation in nulliparous women at term

Wang

Yang

2017

Medicine

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Background:The aim of the study was to assess the efficacy and safety of remifentanil for pain relief during external cephalic version (ECV) for breech presentation in nulliparous women at term.Methods:A total of 144 nulliparous women with singleton breech presentation were randomly divided into the intervention group and the placebo group, with 72 subjects in each group. The subjects in the intervention group received remifentanil (infused at 0.1 μg kg–1 min–1 with demand boluses of 0.1 μg/kg), whereas those in the placebo group were given saline placebo. This study was conducted from May 2013 to April 2016. The outcomes measures include pain (measured with the visual analog scale, VAS), success rate of ECV, maternal satisfaction for ECV, and adverse events.Results:A total of 137 participants completed the study. The intervention with remifentanil showed greater efficacy than did placebo in decreasing the VAS score immediately after ECV (intervention group 4.3 ± 2.2 vs placebo group 6.4 ± 2.5, P < 0.01). A significant difference in the ECV success rate was also found between the 2 groups (intervention group 56.9% vs placebo group 38.9%, P = 0.03). In addition, a significant difference in the satisfaction score was also detected (intervention group 9.3 ± 0.9 vs placebo group 6.7 ± 1.2, P < 0.01). The observed adverse events were similar between the 2 groups.Conclusion:This study shows that remifentanil could decrease pain, improve the ECV success rate, and improve satisfaction in nulliparous women at term during the period of ECV. Furthermore, it is also well tolerated with few adverse events.

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Anesthesia for Non-delivery Obstetric Procedures

et al. 2018

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Increased pain relief with remifentanil does not improve the success rate of external cephalic version: a randomized controlled trial

Abstract: Remifentanil for analgesia decreased external cephalic version-related pain but did not increase the success rate of external cephalic version at term and appeared to be associated with an increased frequency of mild adverse effects.

Cited by 14 publications

References 28 publications

A randomized trial of remifentanil for analgesia in external cephalic version for breech presentation

A randomized trial of remifentanil for analgesia in external cephalic version for breech presentation

Remifentanil analgesia during external cephalic version for breech presentation in nulliparous women at term

Anesthesia for Non-delivery Obstetric Procedures

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