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British Journal of Anaesthesia, 2001, Vol. 87, No. 3 415-420
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Patient-controlled analgesia for labour using remifentanil: a feasibility study

J. M. Blair1, D. A. Hill*,1 and J. P. H. Fee2

1Department of Anaesthetics, The Ulster Hospital, Dundonald, Belfast BT16 0RH, UK. 2Department of Anaesthetics and Intensive Care Medicine, The Queen’s University of Belfast, Belfast, UK*Corresponding author

We have investigated the efficacy and safety of remifentanil in a patient-controlled analgesia device for labour in 21 women. Remifentanil was available in increasing doses (bolus doses 0.25–1.0 µg kg–1) with and without a background infusion (0.025–0.05 µg kg–1 min–1). A lockout time of 2 min was used. Thirteen out of 21 (62%) women chose to continue using remifentanil up to and during delivery. Nineteen out of 21 (90%) achieved a reduction in pain score from baseline. Using a VAS of 0–10 cm the median maximum reduction in pain score was 3 cm (range 0–8 cm). There was a significant reduction (P<0.05) from baseline pain scores (median= 8 cm) to scores at bolus doses in the range 0.25–0.5 µg kg–1 (median=5 cm). There were no significant reductions in the fetal heart rate. Apgar scores and cord blood gas analyses remained within normal limits. We conclude that a remifentanil patient-controlled analgesia system (bolus doses 0.25–0.5 µg kg–1, without a background infusion) may safely provide worthwhile, although incomplete, analgesia for labour.

Br J Anaesth 2001; 87: 415–20


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