Related Experiment Videos
Remifentanil as analgesia for labor
Eliane C S Soares1, Michelle R Lucena, Renata C Ribeiro
1Hospital Municipal Odilon Behrens, Belo Horizonte, MG. elianecssoares@gmail.com
Revista Brasileira De Anestesiologia
|August 5, 2010
Summary
Remifentanil offers a promising alternative for labor pain relief when neuraxial analgesia is not feasible. This opioid provides effective pain management with acceptable side effects for mothers and babies.
Area of Science:
- Obstetrics and Gynecology
- Anesthesiology
- Pharmacology
Background:
- Neuraxial techniques, such as epidural blocks, are the gold standard for labor pain management.
- Maternal contraindications or technical difficulties can limit the use of neuraxial analgesia.
- Alternative pain relief options during labor are currently limited and often ineffective.
Purpose of the Study:
- To review available literature on remifentanil as an alternative labor analgesia technique.
- To discuss the pharmacokinetics, efficacy, and safety of remifentanil for labor pain.
- To evaluate maternal satisfaction and potential side effects of remifentanil use.
Main Methods:
- Literature review of existing studies on remifentanil for labor analgesia.
- Analysis of pharmacokinetic data, efficacy, and safety profiles.
- Assessment of maternal satisfaction and adverse events.
Main Results:
- Remifentanil demonstrates potential as an effective labor analgesia option.
- Data on pharmacokinetics, efficacy, and side effects are presented.
- Maternal satisfaction and safety require further comprehensive evaluation.
Conclusions:
- Remifentanil is a promising alternative for labor analgesia when neuraxial methods are contraindicated or declined.
- Further research is warranted to fully establish its role and optimize its use.
Related Concept Videos
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:24Parenteral Anesthetics: Overview
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
01:24Local Anesthetics: Differential Sensitivity of Nerve Fibers
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
01:25Analgesia and Pain Management
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...