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Must we press on until a young mother dies? Remifentanil patient controlled analgesia in labour may not be suited as a "poor man's epidural"

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Kranke, Peter Girard, Thierry Lavand'homme, Patricia [UCL] Melber, Andrea Jokinen, Johanna Hönig, Arnd

The epidural route is still considered the gold standard for labour analgesia, although it is not without serious consequences when incorrect placement goes unrecognized, e.g. in case of intravascular, intrathecal and subdural placements. Until now there has not been a viable alternative to epidural analgesia especially in view of the neonatal outcome and the need for respiratory support when long-acting opioids are used via the parenteral route. Pethidine and meptazinol are far from ideal having been described as providing rather sedation than analgesia, affecting the cardiotocograph (CTG), causing fetal acidosis and having active metabolites with prolonged half-lives especially in the neonate. Despite these obvious shortcomings, intramuscular and intravenously administered pethidine and comparable substances are still frequently used in delivery units. Since the end of the 90 ths remifentanil administered in a patient-controlled mode (PCA) had been reported as a useful alternative for labour analgesia in those women who either don't want, can't have or don't need epidural analgesia.

Document type Article de périodique (Journal article) – Synthèse de littérature
Access type Accès libre
Publication date 2013
Language Anglais
Journal information "BMC Pregnancy and Childbirth" - Vol. 13, no.1, p. 139 [1-8] (2013)
Peer reviewed yes
Publisher BioMed Central Ltd. ((United Kingdom) London)
issn 1471-2393
e-issn 1471-2393
Publication status Publié
Affiliations UCL - (SLuc) Service d'anesthésiologie
UCL - SSS/IONS - Institute of NeuroScience
UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire
MESH Subject Analgesia, Epidural ; Pregnancy ; Analgesia, Patient-Controlled ; Analgesics, Opioid ; Female ; Humans ; Labor, Obstetric ; Nitrous Oxide ; Pain Management ; Piperidines
Links
  1. Hodnett ED: Pain and women’s satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol. 2002, 186: S160-S172.
  2. ACOG: Last access: 20 November. Pain Relief During Labor. ACOG Committee on Obstetric Practice 2004, Number 295. 2012
  3. Gogarten W, Van Aken H, Kessler P, et al: Durchführung von Analgesie- und Anästhesieverfahren in der Geburtshilfe. Anästh Intensivmed. 2009, 50: S502-S507.
  4. Goetzl LM: ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists Number 36, July 2002. Obstetric analgesia and anesthesia. Obstet Gynecol. 2002, 100: 177-191.
  5. IASP: Declaration of Montreal: Declaration that Access to Pain Management Is a Fundamental Human Right. 2012, last access: 20 November, http://www.iasp-pain.org/PainSummit/DeclarationOfMontreal.pdf ,
  6. Freeman Liv M, Bloemenkamp Kitty WM, Franssen Maureen TM, Papatsonis Dimitri NM, Hajenius Petra J, van Huizen Marloes E, Bremer Henk A, van den Akker Eline SA, Woiski Mallory D, Porath Martina M, van Beek Erik, Schuitemaker Nico, van der Salm Paulien CM, Fong Bianca F, Radder Celine, Bax Caroline J, Sikkema Marko, van den Akker-van Marle M Elske, van Lith Jan MM, Lopriore Enrico, Uildriks Renske J, Struys Michel MRF, Mol Ben Willem J, Dahan Albert, Middeldorp Johanna M, Remifentanil patient controlled analgesia versus epidural analgesia in labour. A multicentre randomized controlled trial, 10.1186/1471-2393-12-63
  7. AWMF: S3-Leitlinie Behandlung akuter perioperativer und posttraumatischer Schmerzen. 2012, last access: 20 November, http://www.awmf.org/uploads/tx_szleitlinien/041-001_S3_Behandlung_akuter_perioperativer_und_posttraumatischer_Schmerzen_aktualisierte_Fassung_04-2009_05-2011.pdf 2009
  8. Olofsson Ch., Ekblom A., Ekman-Ordeberg G., Hjelm A., Irestedt L., Lack of analgesic effect of systemically administered morphine or pethidine on labour pain, 10.1111/j.1471-0528.1996.tb09545.x
  9. Tsui Michelle H.Y., Ngan Kee Warwick D., Ng Floria F., Lau Tze K., A double blinded randomised placebo-controlled study of intramuscular pethidine for pain relief in the first stage of labour, 10.1111/j.1471-0528.2004.00160.x
  10. Ullman R, Smith LA, Burns E, Mori R, Dowswell T: Parenteral opioids for maternal pain relief in labour. Cochrane Database Syst Rev. 2010, CD007396, 9
  11. TVEIT T. O., HALVORSEN A., ROSLAND J. H., Analgesia for labour: a survey of Norwegian practice - with a focus on parenteral opioids, 10.1111/j.1399-6576.2009.01988.x
  12. Schnabel A., Hahn N., Muellenbach R., Frambach T., Hoenig A., Roewer N., Kranke P., Geburtshilfliche Analgesie in deutschen Kliniken : Remifentanil als Alternative zur Regionalanalgesie, 10.1007/s00101-011-1933-9
  13. Jankovic K, IASP: Guide to Pain Management in Low-Resource Settings. Chapter 17: Pharmacological Management of Pain in Obstetrics. 2012, Last access: 21 November, http://www.iasp-pain.org/AM/Template.cfm?Section=Home%26Template=/CM/ContentDisplay.cfm%26ContentID=12180 2012
  14. SHEIKH A., TUNSTALL M. E., Comparative study of meptazinol and pethidine for the relief of pain in labour, 10.1111/j.1471-0528.1986.tb07905.x
  15. Nel CP, Bloch B, Rush JM: A comparison of meptazinol and pethidine for pain relief during the first stage of labour. S Afr Med J. 1981, 59: 908-910.
  16. IRESTEDT L., Current status of nitrous oxide for obstetric pain relief, 10.1111/j.1399-6576.1994.tb04002.x
  17. Klomp T, Van Poppel M, Jones L, Lazet J, Di Nisio M, Lagro-Janssen AL: Inhaled analgesia for pain management in labour. Cochrane Database Syst Rev. 2012, 9: CD009351-
  18. Rosen Mark A., Nitrous oxide for relief of labor pain: A systematic review, 10.1016/s0002-9378(02)70186-5
  19. Shu Yi, Patel Shivali M., Pac-Soo Chen, Fidalgo António Rei, Wan Yanjie, Maze Mervyn, Ma Daqing, Xenon Pretreatment Attenuates Anesthetic-induced Apoptosis in the Developing Brain in Comparison with Nitrous Oxide and Hypoxia : , 10.1097/aln.0b013e3181d960d7
  20. Volmanen P., Akural E., Raudaskoski T., Ohtonen P., Alahuhta S., Comparison of remifentanil and nitrous oxide in labour analgesia, 10.1111/j.1399-6576.2005.00639.x
  21. Jones R., Pegrum A., Stacey R. G. W., Patient-controlled analgesia using remifentanil in the parturient with thrombocytopaenia, 10.1046/j.1365-2044.1999.00857.x
  22. Thurlow J. A., Waterhouse P., Patient-controlled analgesia in labour using remifentanil in two parturients with platelet abnormalities, 10.1093/oxfordjournals.bja.a013452
  23. Roelants Fabienne, De Franceschi Emmanuelle, Veyckemans Francis, Lavand’homme Patricia, Patient-controlled intravenous analgesia using remifentanil in the parturient, 10.1007/bf03019731
  24. D’Onofrio Paola, Novelli Anna Maria Melani, Mecacci Federico, Scarselli Gianfranco, The Efficacy and Safety of Continuous Intravenous Administration of Remifentanil for Birth Pain Relief: An Open Study of 205 Parturients : , 10.1213/ane.0b013e3181acc6fc
  25. Manullang Theodore R., Chun Katharine, Egan Talmage D., The use of remifentanil for cesarean section in a parturient with recurrent aortic coarctation, 10.1007/bf03018976
  26. McCarroll C. P., Paxton L. D., Elliott P., Wilson D. B., Use of remifentanil in a patient with peripartum cardiomyopathy requiring Caesarean section, 10.1093/bja/86.1.135
  27. HEESEN M., KLÖHR S., HOFMANN T., ROSSAINT R., DEVROE S., STRAUBE S., VAN DE VELDE M., Maternal and foetal effects of remifentanil for general anaesthesia in parturients undergoing caesarean section: a systematic review and meta-analysis : Meta-analysis of remifentanil for caesarean section, 10.1111/j.1399-6576.2012.02723.x
  28. Hill David, Remifentanil patient-controlled analgesia should be routinely available for use in labour, 10.1016/j.ijoa.2008.03.005
  29. Luzón María José, Scholarly hyperwriting: The function of links in academic weblogs, 10.1002/asi.20937
  30. Schnabel Alexander, Hahn Niklas, Broscheit Jens, Muellenbach Ralf M., Rieger Lorenz, Roewer Norbert, Kranke Peter, Remifentanil for labour analgesia : a meta-analysis of randomised controlled trials, 10.1097/eja.0b013e32834fc260
  31. Tveit Tor O., Seiler Stephen, Halvorsen Arthur, Rosland Jan H., Labour analgesia : a randomised, controlled trial comparing intravenous remifentanil and epidural analgesia with ropivacaine and fentanyl, 10.1097/eja.0b013e32834dfa98
  32. Douma M.R., Middeldorp J.M., Verwey R.A., Dahan A., Stienstra R., A randomised comparison of intravenous remifentanil patient-controlled analgesia with epidural ropivacaine/sufentanil during labour, 10.1016/j.ijoa.2010.11.009
  33. Bonner J. C., McClymont W., Respiratory arrest in an obstetric patient using remifentanil patient-controlled analgesia* : Respiratory arrest with remifentanil PCA, 10.1111/j.1365-2044.2011.06997.x
  34. Pruefer C., Bewlay A., Respiratory arrest with remifentanil patient-controlled analgesia - another case : Correspondence, 10.1111/j.1365-2044.2012.07273.x
  35. Sneyd R., Remifentanil on the labour ward : Correspondence, 10.1111/j.1365-2044.2012.07307.x
  36. Sneyd J.R., Off-label use of medicines is bad medicine flying the flag of clinical freedom, 10.1016/j.ijoa.2009.03.008
  37. Bogod D.G., Off-licence use of medicines is bad medicine flying the flag of clinical freedom, 10.1016/j.ijoa.2009.03.007
  38. Frambach T., Wirbelauer J., Schelling P., Rieger L., Muellenbach R. M., Roewer N., Kranke P., Remifentanil zur geburtshilflichen Schmerzerleichterung per patientenkontrolliertem Analgesieverfahren: Fallserie und Diskussion medikolegaler Aspekte, 10.1055/s-0030-1255025
  39. Kranke PD, Schelling Philip, Frambach Torsten, Wirbelauer Johannes, Leser fragen – Experten antworten – Remifentanil zur geburtshilflichen Analgesie: eine echte Alternative zum Epiduralkatheter?, 10.1055/s-0029-1242434
  40. Kranke Peter, Lavand’homme Patricia, The relief of pain in labour and the role of remifentanil : , 10.1097/eja.0b013e32834f986d
  41. Ismail Mohamed Taha, Hassanin Maher Z., Neuraxial analgesia versus intravenous remifentanil for pain relief in early labor in nulliparous women, 10.1007/s00404-012-2459-3
  42. Douma M. R., Verwey R. A., Kam-Endtz C. E., van der Linden P. D., Stienstra R., Obstetric analgesia: a comparison of patient-controlled meperidine, remifentanil, and fentanyl in labour, 10.1093/bja/aep359
  43. Eisenach James C., Pan Peter H., Smiley Richard, Lavand’homme Patricia, Landau Ruth, Houle Timothy T., Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression : , 10.1016/j.pain.2008.07.011
  44. Konopka K.- H., van Wijhe M., Opioid-induced hyperalgesia: pain hurts?, 10.1093/bja/aeq286
  45. Lee Lorri, Weinger Matthew B., Anesthesia Patient Safety Foundation Consensus Conference Report : Essential Monitoring Strategies to Detect Clinically Significant Drug-Induced Respiratory Depression in the Postoperative Period, 10.1213/ane.0b013e31823ac835
  46. Greene Michael F., Two Hundred Years of Progress in the Practice of Midwifery, 10.1056/nejmra1209764
  47. Tveit T.O., Halvorsen A., Seiler S., Rosland J.H., Efficacy and side effects of intravenous remifentanil patient-controlled analgesia used in a stepwise approach for labour: an observational study, 10.1016/j.ijoa.2012.09.003
  48. Anonymous: The Lancet. London: Saturday, May 14, 1853. Lancet. 1953, 61: 453-
  49. . Glass Peter S.A, A Trial of Labor For Remifentanil : , 10.1097/00000539-200204000-00001
  50. Hollmann Markus W, Strümper Danja, Durieux Marcel E, The poor man's epidural: systemic local anesthetics for improving postoperative outcomes, 10.1016/j.mehy.2004.02.057
  51. Volmanen Petri, Palomäki Outi, Ahonen Jouni, Alternatives to neuraxial analgesia for labor : , 10.1097/aco.0b013e328345ad18
Bibliographic reference Kranke, Peter ; Girard, Thierry ; Lavand'homme, Patricia ; Melber, Andrea ; Jokinen, Johanna ; et. al. Must we press on until a young mother dies? Remifentanil patient controlled analgesia in labour may not be suited as a "poor man's epidural". In: BMC Pregnancy and Childbirth, Vol. 13, no.1, p. 139 [1-8] (2013)
Permanent URL http://hdl.handle.net/2078.1/156743