Remifentanil by patient-controlled analgesia compared with intramuscular meperidine for pain relief in labour

Background. The pharmacokinetics of remifentanil suggests thatit may be suitable for analgesia during labour. Methods. In an open pilot study, 36 women requesting meperidinefor analgesia were recruited early in labour and randomizedto receive either meperidine i.m. or remifentanil given as patient-controlledanalgesia (PCA). Pain severity, sedation and anxiety were assessedwith visual analogue scales and overall effective analgesiawas assessed by the woman and midwife. Results. The pain scores were lower in the remifentanil group:median pain score at 60 min was 72 mm for meperidineand 48 mm for remifentanil (P=0.004) and median maximumpain score during the first 2 h was 82.5 mm for themeperidine group and 66.5 mm for the remifentanil group(P=0.009). Both the midwives’ and the women’s assessmentsof overall effective analgesia were higher in the remifentanilgroup [Likert scale (5 = excellent to 1 = poor):