The Comparison of Patient-Controlled Remifentanil Administered by Two Different Protocols (Bolus and Bolus+Infusion) and Intramuscular Meperidine for Labor Analgesia
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Original Article
P: 264-269
October 2014

The Comparison of Patient-Controlled Remifentanil Administered by Two Different Protocols (Bolus and Bolus+Infusion) and Intramuscular Meperidine for Labor Analgesia

Turk J Anaesthesiol Reanim 2014;42(5):264-269
1. Özel Tarsus Medikal Park Hastanesi, Anesteziyoloji Kliniği, Mersin, Türkiye
2. Çukurova Üniversitesi Tıp Fakültesi, Anesteziyoloji Anabilim Dalı, Adana, Türkiye
3. Çukurova Üniversitesi Tıp Fakültesi, Kadın ve Doğum Hastalıkları Anabilim Dalı, Adana, Türkiye
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Received Date: 30.09.2013
Accepted Date: 11.11.2013
Publish Date: 09.07.2014
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ABSTRACT

Objective:

Nowadays, there are many pain relief methods for reducing the pain and stress of labor and delivery. In our study, two different remifentanil protocols (bolus and bolus+infusion) administered by patient-controlled analgesia method were compared with intramuscular meperidine for labor analgesia.

Methods:

Ninety parturients who were scheduled for vaginal delivery were included in this study. Patients were randomly divided into 3 groups, with 15 primiparous and 15 multiparous patients in each group. Whenever a patient requested analgesics during the labor, Group M was given 1 mg kg-1 intramuscular meperidine, Group B was given intravenous bolus patient-controlled remifentanil, and Group IB was given intravenous bolus+infusion patient-controlled remifentanil. Patients’ systolic and diastolic blood pressure, heart rate, pain-comfort and sedation scores, remifentanil consumption, side effects, and Apgar scores of newborns were evaluated during the labor and delivery.

Results:

Patients’ mean pain and comfort scores were significantly lower in Groups B and IB than in Group M at all time intervals except the first minute. Compared with Group IB, mean pain and comfort scores at 15, 30, 60, and 120 minutes were significantly higher in Group B. The mean sedation scores were similar among the groups. Total remifentanil consumption was lower in Group IB than in Group B, but it was not statistically significant.

Conclusion:

Patient-controlled intravenous bolus or bolus+infusion remifentanil provided more effective analgesia and patient comfort than intramuscular meperidine for labor analgesia. Especially during labor, bolus+infusion remifentanil administration provided better pain and patient comfort scores than bolus alone, without increasing remifentanil consumption.