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@article{1344196,
author = {Štourač, Petr and Kosinová, Martina and Harazim, Hana and Huser, Martin and Janků, Petr and Littnerová, Simona and Jarkovský, Jiří},
article_location = {Olomouc},
article_number = {1},
doi = {http://dx.doi.org/10.5507/bp.2015.043},
keywords = {remifentanil; labour analgesia; patient-controlled analgesia; systemic opioid analgesia; meta-analysis},
language = {eng},
issn = {1213-8118},
journal = {Biomedical Papers, Olomouc: Palacky University},
title = {The analgesic efficacy of remifentanil for labour. Systematic review of the recent literature},
volume = {160},
year = {2016}
}
TY - JOUR
ID - 1344196
AU - Štourač, Petr - Kosinová, Martina - Harazim, Hana - Huser, Martin - Janků, Petr - Littnerová, Simona - Jarkovský, Jiří
PY - 2016
TI - The analgesic efficacy of remifentanil for labour. Systematic review of the recent literature
JF - Biomedical Papers, Olomouc: Palacky University
VL - 160
IS - 1
SP - 30-38
EP - 30-38
PB - Palacky University
SN - 12138118
KW - remifentanil
KW - labour analgesia
KW - patient-controlled analgesia
KW - systemic opioid analgesia
KW - meta-analysis
N2 - Background and Aims. Although epidural analgesia is still regarded as the gold standard for labour analgesia due to its efficacy, in cases of contraindication, systemic remifentanil is an alternative. Since the first demonstration of the safety of remifentanil in obstetric analgesia in 1996, this has been repeatedly confirmed for both mother and newborn. The aim of this meta-analysis is to evaluate recently published studies (up to December 2014) on the analgesic efficacy of remifentanil during labour (as a Visual Analogue Scale (VAS) decrease in the first hour by 2 or more). Methods. Search of the US National Library of Medicine, National Institutes of Health (www.pubmed.gov), SCOPUS database (www.scopus.com) and Web of Science database (www.webofknowledge.com) using the key words "labour" and "remifentanil". 44 identified articles were included in the review and 15 published randomised controlled studies were incorporated into the meta-analysis. This was based on the fixed model and described by differences in the VAS between t=0 and t=1 hour after remifentanil administration using the 95% confidence interval (CI). The analysis was computed using the Comprehensive meta-analysis version 2.2.064. Results. The combined data from the meta-analysis showed a statistically significant decrease in VAS in the remifentanil group. From a comparison of the CIs of summary estimates with a cut-off decrease of VAS 2, for the fixed model, there was a statistically significantly greater decrease in VAS than the cut-off. In the systematic review, we describe possible modes of application, dosage and side-effects for mother, fetus/newborn. Conclusion. The meta-analysis presented here confirms that remifentanil for labour analgesia is effective but questions remain which can only be answered by further randomized trials.
ER -
ŠTOURAČ, Petr, Martina KOSINOVÁ, Hana HARAZIM, Martin HUSER, Petr JANKŮ, Simona LITTNEROVÁ a Jiří JARKOVSKÝ. The analgesic efficacy of remifentanil for labour. Systematic review of the recent literature. \textit{Biomedical Papers, Olomouc: Palacky University}. Olomouc: Palacky University, roč.~160, č.~1, s.~30-38. ISSN~1213-8118. doi:10.5507/bp.2015.043. 2016.
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