• Marc Van de Velde.
• aDepartment of Cardiovascular Sciences bDepartment of Anesthesiology, UZ Leuven, Leuven, Belgium.
• Curr Opin Anaesthesiol. 2015 Jun 1;28(3):237-9.

Purpose Of ReviewRemifentanil is a relatively new but commonly used opioid alternative in the management of labor pain relief. The present article evaluates efficacy and safety of patient-controlled intravenous analgesia (PCIA) with remifentanil in the management of labor pain relief.Recent FindingsRemifentanil PCIA provides analgesia that is superior to nitrous oxide or other opioids such as meperidine, but is less effective when compared with epidural analgesia. Recent evidence suggests it produces significant respiratory depression making routine use as first line analgesia strategy virtually impossible.SummaryRemifentanil PCIA is a valuable analgesic strategy whenever regional analgesia is contraindicated. Using it as first line strategy seems to be contraindicated because of significant respiratory side-effects to the mother. Whenever used advanced and continuous monitoring using capnography, saturation monitoring and one-to-one midwifery care are mandatory!

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