Patient controlled remifentanil and epidural analgesia during labour : satisfaction, costs and safety

Epidural analgesia provided superior analgesia to remifentanil PCA. Women randomised to epidural analgesia with a request for pain relief are more satisfied with their analgesia than women randomised to remifentanil PCA. Costs of epidural analgesia and remifentanil PCA are not significantly different. From an economic perspective, there is no preferential pain treatment in labouring women. Epidural analgesia is associated with a greater incidence of fever and significantly higher temperature overall. Patient controlled remifentanil has an effect on maternal SpO2 with significantly lower mean SpO2 during the labour period. This shows that respiratory complications are a serious problem associated with remifentanil and that continuous monitoring by trained personnel is obligatory. Persistent postpartum pain affects many women. Of surveyed women, 6.1% complained of significant pain related to delivery. Since this was a retrospective follow up study this results might be explained by the study design and these findings have to be evaluated by further research.