Intravenous Remifentanil Patient-controlled Analgesia (PCA) and Epidural Patient Controlled Epidural Analgesia (PCEA) for Labor Analgesia

Comparison of the Efficacy Intravenous Remifentanil PCA and Epidural PCEA for Labor Analgesia

Women requesting analgesia do not always wish to receive a potent analgesic method, and may fear the risks of epidural analgesia.

Study Aim: To determine whether remifentanil is effective for labor analgesia when compared with standard treatment (epidural analgesia).

Inclusion criteria:

• Healthy women
• American Society of Anesthesiologists physical status class I or II
• Body weight less than 110 kg
• In active labor (including induced labor and premature rupture of membranes)
• Cervical dilatation at 2-6 cm
• Regular contractions
• Age between 18 and 40 years old
• Gestational age greater than 36 completed weeks
• Singleton pregnancy and vertex presentation

Exclusion criteria:

• Contraindication for epidural analgesia (bleeding diathesis, neuropathy, severe scoliosis, previous spine surgery, local anesthetic allergy)
• Narcotic administration in the previous 2 hours
• Previous uterine surgery
• Pre-eclampsia and the inability to adequately understand the consent form
• Blocked nose, and any indication patient for whom epidural analgesia is medically indicated (cardiac disease, suspected difficult airway)