(Acta Obstet Gynecol Scand. 2015;94(9):1014–1021)
Remifentanil is a short-acting opioid that is able to metabolize quickly through nonspecific tissue esterases with peak onset at 60 to 90 seconds. Patient-controlled remifentanil is now used for labor analgesia on some units, and several studies have positively evaluated the safety and efficacy of its use. However, it is associated with infrequent but serious side effects impacting patient respiration. Epidural analgesia is currently seen as the best option for labor analgesia, but it carries its own side effects, including postdural puncture headache, hypotension, an increased risk for instrumental deliveries, and increased body temperature that can make maternal infections more difficult to detect. The authors of this study compared these 2 methods of analgesia according to levels of patient satisfaction.