A randomized trial of remifentanil for analgesia in external cephalic version for breech presentation.

Abstract

BACKGROUND:

Although external cephalic version (ECV) can be effective for correcting the fetus in a cephalic presentation, it may be painful for the mother. This study aimed to evaluate the efficacy and safety of remifentanil for pain relief during ECV in China.

METHODS:

In all, 152 Chinese parturients with singleton breech presentation were randomly divided into 2 groups, each with 76 patients. All 152 patients were assigned to receive either remifentanil (infused at 0.1 μg/kg/min and demand boluses of 0.1 μg/kg) or saline placebo. The study was performed between January 2012 and December 2015. Outcome measurements included the Numerical Rating Pain Scale score (0-10) after ECV, success rate for ECV, and maternal satisfaction after ECV. Adverse events were also evaluated.

RESULTS:

The study was completed by 146 patients. Remifentanil showed greater efficacy than placebo in decreasing the pain score immediately after ECV (remifentanil 4.6 ± 2.6 vs placebo 6.5 ± 2.7; P < 0.001). The success rate for ECV showed a significant difference between the 2 groups (remifentanil 56.5% vs placebo 39.5%; P = 0.04). Maternal satisfaction also showed a significant difference between the 2 groups (remifentanil 9.6 ± 1.4 vs placebo 6.4 ± 3.7; P < 0.001). However, the adverse events profiles were similar between both groups.

CONCLUSION:

The results of this study demonstrate that remifentanil is an effective intervention for reducing pain, achieving successful ECV, and increasing maternal satisfaction during ECV, and is generally well-tolerated without additional adverse effects.

• Authors: Xiaohua Liu, Aiqin Xue
• Journal: Medicine (Medicine (Baltimore)) Vol. 95 Issue 49 Pg. e5483 (Dec 2016) ISSN: 1536-5964 [Electronic] United States
• PMID: 27930530 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Analgesics, Opioid
• Piperidines
• Remifentanil

Topics

• Adult
• Analgesics, Opioid (administration & dosage)
• Anesthesia, Obstetrical (methods)
• Breech Presentation
• Female
• Humans
• Infant, Newborn
• Pain Measurement
• Piperidines (administration & dosage)
• Pregnancy
• Remifentanil
• Treatment Outcome
• Version, Fetal