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The efficacy and safety of remifentanil patient-controlled versus epidural analgesia in labor: A meta-analysis and systematic review

Author

Listed:
  • Xiuzhen Lei
  • Yang Yu
  • Mei Li
  • Peng Fang
  • Shuyuan Gan
  • Yongxing Yao
  • Yanfeng Zhou
  • Xianhui Kang

Abstract

Background: Remifentanil patient-controlled analgesia (rPCA) and epidural analgesia (EA) has been used for pain relief in labor. We aimed to evaluate the efficacy and safety of rPCA versus EA in labor, to provide evidence support for clinical analgesia and pain care. Methods: We searched PubMed, EMBASE, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang and Weipu databases for RCTs comparing rPCA and EA in labor until February 15, 2022. Two researchers independently screened literature and extracted data. RevMan 5.3 software was used for data analysis. Results: A total of 10 RCTs involving 3086 parturients were enrolled, 1549 parturients received rPCA and 1537 received EA. Meta-analysis indicated that the incidence of intrapartum maternal fever within 1 hour of labor analgesia (OR = 0.43, 95%CI: 0.30~0.62), after 1 hour of labor analgesia (OR = 0.42, 95%CI: 0.20~0.90) in the rPCA was significantly less than that of EA (all P 0.05). Conclusion: rPCA can be an optional alternative to EA with similar pain relief and less risk of intrapartum maternal fever. However, rPCA was associated with increased risk of respiratory depression. Future studies with rigorous design and larger sample size are needed to provide more reliable evidences for clinical rPCA and EA use.

Suggested Citation

  • Xiuzhen Lei & Yang Yu & Mei Li & Peng Fang & Shuyuan Gan & Yongxing Yao & Yanfeng Zhou & Xianhui Kang, 2022. "The efficacy and safety of remifentanil patient-controlled versus epidural analgesia in labor: A meta-analysis and systematic review," PLOS ONE, Public Library of Science, vol. 17(12), pages 1-14, December.
    • Handle: RePEc:plo:pone00:0275716
    DOI: 10.1371/journal.pone.0275716
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