The Role of Remifentanil in Obstetric Analgesia: A Review

Standard for labour analgesia due to its efficacy. In cases of contraindication, systemic remifentanil is possible as alternative. The first demonstration of the safety of remifentanil in obstetric analgesia was in 1996 and since then, its safety for mother and newborn has been repeatedly confirmed. The aim of this review is to provide a summary of current information on the efficacy and safety of remifentanil during labour. Methods: Search of the US National Library of Medicine, National Institutes of Health (www.pubmed.gov), SCOPUS database (www.scopus.com) and Web of Science database (www.webofknowledge.com) using the key words “labour” and “remifentanil.” Results: Forty four identified articles were included into review. We described possible modes of application, dosage and side-effects for mother, fetus or newborn in the review. Conclusion: Administration of remifentanil is appropriate, effective, and with respects to the mentioned safety principles also a safe alternative to epidural analgesia in labour. It is highly satisfactory and comparable to epidural analgesia for parturients despite the fact that the analgesic efficacy is significantly lower. Compared to other systemically applied opioids or nitrous oxide, it is more efficient analgesic and due to its unique pharmacokinetics also a safer option. To determine the optimal dosage and mode of administration of remifentanil further studies are needed.