Remifentanil in Labour
What is Remifentanil?
Remifentanil is a strong opiate analgesia which has very short lasting effect and makes it an ideal drug to use with a pump or PCA. (Patient Controlled Analgesia)
How do I use Remifentanil?
- A drip and the PCA is set up by an anaesthetist who will give you a button to hold. When you feel a contraction coming on you press the button.
- When you press the button, the drug is administered through the drip into a vein, making it very quick to take effect.
- It can make you sleepy, but the contraction pains start to fade away.
- By the time your contraction has gone you wouldn't know that you had one!
- It is very easy to use, however you would need close monitoring of Blood pressure and saturation's. The reason for this is the drug can suppress your breathing or slow it down and therefore needs to be monitored.
- The pump itself has inbuilt safety features so that you could never overdose yourself.
Advantages of Remifentanil PCA
- A very effective pain relief in labour without the need of an epidural
- Controlled by you
- Easy to use
- Quick to set up by an anaesthetist
- Can use Entonox with this
- Side effects are short lasting
- Can stop using whenever you need to ie. for Pushing.
- Has no direct effects on the baby.
Disadvantages of Remifentanil PCA
- Makes you drowsy
- Need to time it right to press the button just as the contraction is building up.
- Unable to mobilise in labour, restricted to the bed.
- Mum Continuously monitored and sometimes need oxygen.
- Women find it hard to have the energy to push when fully dilated as they are too drowsy.
- Higher risk of having an instrumental delivery (forceps or Ventouse)
- Side effects are short lasting but women experience itching, nausea, drowsiness, and slower breathing.
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