Obstetric Anaesthesiology
1840
Are pregnant women satisfied with remifentanil labour analgesia?
Analgesia,obstetric
S. Oliveira1, C. Lanzaro1, L. Ferreira1, A. Bernardino1
1CHUC - Coimbra (Portugal)

Background and Goal of Study:Remifentanil intravenous patient-controlled analgesia (rIVPCA) has pharmacological properties that make it a popular alternative to epidural labour analgesia. Despite the adverse effects, evidence suggests that rIVPCA is a feasible alternative to neuraxial analgesia when this is contraindicated, unavailable or not preferred by pregnant women. However, there is a lack of evidence of the satisfaction with rIVPCA. The aim of the study was to evaluate satisfaction and pain relief with rIVPCA for labour analgesia.
Materials and Methods:A retrospective descriptive study was undertaken to assess pregnant women satisfaction with rIVPCA in labour pain. All women delivering live births and receiving rIVPCA between January 2016 and June 2017 were included and contacted by telephone to answer a satisfaction questionnaire. Respective clinical records were consulted. The outcomes analysed were overall satisfaction (0=very dissatisfied, 1=dissatisfied, 2=neutral, 3=satisfied, 4=very satisfied), pain relief degree (0= very poor, 1=poor, 2=moderate, 3=good, 4=very good), maternal side effects and neonatal outcome.
Results and Discussion:During the period of the study 3682 births occurred. Only 30 women received rIVPCA and 87% of them (n=26) answered the interview. The mean age was 31.5±3.4, most had concluded high school or had a graduation and 54% were nulliparous. Most had a spontaneous delivery (65%), in 19% was instrumental and 15% ended in caesarean section. The main reason for the choice of this type of analgesia was bleeding disorders (42%). In terms of the overall satisfaction, 4% were very satisfied, 34% satisfied, 19% neutral, 31% dissatisfied and 12% very dissatisfied. The pain relief was good for 8%, moderate for 38%, poor for 23% and very poor for 31%. Fifteen women (58%) would like to repeat this analgesic option. Twelve women had tried epidural analgesia before and 10 of them preferred this analgesia. Side effects occurred in 16 women (62%) with sedation being the most common (46%), followed by dizziness (19%) and nausea (12%). The median Apgar score was 9/10/10. We did not find any association with maternal variables and satisfaction or pain relief scores.
Conclusion:Our study shows that rIVPCA provides modest scores of satisfaction and pain relief with frequent side effects but normal neonatal outcome. More research and possibly more satisfactory analgesic options in alternative to epidural analgesia are needed.


02 / Are pregnant women satisfied with remifentanil labour analgesia?