What is remifentanil PCA?
Remifentanil PCA is a form of pain relief that can be used in labour on the Rosie delivery unit. Remifentanil is an opiate pain-relieving drug like pethidine or morphine, but it is very short acting.
Is remifentanil the same as pethidine?
Remifentanil patient-controlled analgesia (PCA) in labour is an alternative to pethidine, but is not widely used.
Why is remifentanil used in labour?
Remifentanil is a synthetic opioid (anilidopiperidine) with direct agonist action specifically on μ-opioid receptors . The rapid onset and offset of the drug make remifentanil very suitable for administration via patient controlled analgesia (PCA), which can be used for analgesia during labour.
Is remifentanil an epidural?
Conclusion In women in labour, patient controlled analgesia with remifentanil is not equivalent to epidural analgesia with respect to scores on satisfaction with pain relief. Satisfaction with pain relief was significantly higher in women who were allocated to and received epidural analgesia.
What does remifentanil feel like?
Remifentanil can make you feel sleepy, sick, dizzy or itchy. These stop once you stop taking the medicine. Like pethidine, remifentanil can affect the baby’s breathing but this usually wears off quickly.
When can I have an epidural during labour?
You usually only have an epidural during the first stage of labour — but it can be given at any stage of labour.
Is pethidine still used for childbirth?
Sometimes, pethidine is still used to help relieve labour pain during childbirth. In recent years, however, pethidine has been used less frequently in labour wards since morphine has been shown to give longer-lasting pain relief with fewer side effects.
What are the side effects of having an epidural?
Side effects Epidural
- Low blood pressure. It’s normal for your blood pressure to fall a little when you have an epidural.
- Loss of bladder control.
- Itchy skin.
- Feeling sick.
- Inadequate pain relief.
- Slow breathing.
- Temporary nerve damage.
How quickly does remifentanil work?
Pain relief from remifentanil is very fast and often begins in as little as 60 seconds. The drug’s effects completely wear off between 5 and 10 minutes after the medication is stopped.
How does remifentanil feel?
Is it safe to use remifentanil PCA in labour?
This approach is in contrast to the previous warnings from experts against using remifentanil PCA routinely in labour because of safety reasons; it has been recommended that remifentanil should only be used in isolated patients where neuraxial analgesia was contra-indicated 2, 3 and it was assumed that the majority of hospitals worldwide could n…
Does the remipca safe network have a safety standard for remifentanil?
Background: The RemiPCA SAFE Network was established to set standards and monitor maternal and neonatal outcomes when using remifentanil for labour analgesia. The aim of this analysis was to describe the development of the network standard and to report maternal and neonatal outcome data, including severe adverse events.
What is remifentanil used for in labor?
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.
What are the adverse effects of remifentanil PCA?
(i) Data should be routinely collected at a national level on the use of remifentanil PCA in labour and occurrence of adverse outcomes. (ii) Respiratory depression is a common finding over a wide dose range, with great variation in rates reported (5–93%).