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Remifentanil for labor analgesia: a comprehensive review

Journal of Anesthesia volume 30, pages 1020–1030 (2016)Cite this article

An Erratum to this article was published on 21 October 2016

Abstract

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.

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Author information

Authors and Affiliations

  1. Department of Anaesthesia, Fremantle Hospital and Health Service, Alma Street, Fremantle, WA, 6160, Australia

    Yayoi Ohashi

  2. Department of Anesthesiology, South Health Campus, University of Calgary, Calgary, Canada

    Leyla Baghirzada

  3. Department of Anesthesiology, Juntendo University, Tokyo, Japan

    Hiroyuki Sumikura

  4. Department of Anesthesia and Pain Management, Mount Sinai Hospital, University of Toronto, Toronto, Canada

    Mrinalini Balki

Authors
  1. Yayoi Ohashi
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  2. Leyla Baghirzada
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  3. Hiroyuki Sumikura
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  4. Mrinalini Balki
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Corresponding author

Correspondence to Yayoi Ohashi.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s00540-016-2269-z.

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Ohashi, Y., Baghirzada, L., Sumikura, H. et al. Remifentanil for labor analgesia: a comprehensive review. J Anesth 30, 1020–1030 (2016). https://doi.org/10.1007/s00540-016-2233-y

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  • DOI: https://doi.org/10.1007/s00540-016-2233-y

Keywords

  • Remifentanil
  • Obstetric anesthesia
  • Labor analgesia