J 2016

The analgesic efficacy of remifentanil for labour. Systematic review of the recent literature

ŠTOURAČ, Petr, Martina KOSINOVÁ, Hana HARAZIM, Martin HUSER, Petr JANKŮ et. al.

Basic information

Original name

The analgesic efficacy of remifentanil for labour. Systematic review of the recent literature

Authors

ŠTOURAČ, Petr (203 Czech Republic, guarantor, belonging to the institution), Martina KOSINOVÁ (203 Czech Republic), Hana HARAZIM (703 Slovakia, belonging to the institution), Martin HUSER (203 Czech Republic, belonging to the institution), Petr JANKŮ (203 Czech Republic, belonging to the institution), Simona LITTNEROVÁ (203 Czech Republic, belonging to the institution) and Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution)

Edition

Biomedical Papers, Olomouc: Palacky University, Olomouc, Palacky University, 2016, 1213-8118

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30214 Obstetrics and gynaecology

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 0.894

RIV identification code

RIV/00216224:14110/16:00089821

Organization unit

Faculty of Medicine

DOI

UT WoS

000373390800004

Keywords in English

remifentanil; labour analgesia; patient-controlled analgesia; systemic opioid analgesia; meta-analysis

Tags

Tags

International impact, Reviewed
Změněno: 2/8/2016 13:32, Ing. Mgr. Věra Pospíšilíková

Abstract

V originále

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.