NDLI: The analgesic efficacy of remifentanil for labour. Systematic review of the recent literature.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Stourac, Petr Kosinova, Martina Harazim, Hana Huser, Martin Janku, Petr Littnerova, Simona Jarkovsky, Jiri
Description	Country affiliation: Czech Republic Author Affiliation: Stourac P ( Department of Paediatric Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Czech Republic.); Kosinova M ( Obstetric Anaesthesia and Analgesia Section of the Czech Society of Anaesthesiology and Intensive Care Medicine, Czech Republic.); Harazim H ( Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Czech Republic.); Huser M ( Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Czech Republic.); Janku P ( Department of Obstetrics and Gynecology, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Czech Republic.); Littnerova S ( Department of Obstetrics and Gynecology, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Czech Republic.); Jarkovsky J ( Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.)
Abstract	BACKGROUND AND AIMS: Although epidural analgesia is still regarded as the gold standard for labour analgesia due to its efficacy, in cases of contraindication, systemic remifentanil is an alternative. Since the first demonstration of the safety of remifentanil in obstetric analgesia in 1996, this has been repeatedly confirmed for both mother and newborn. The aim of this meta-analysis is to evaluate recently published studies (up to December 2014) on the analgesic efficacy of remifentanil during labour (as a Visual Analogue Scale (VAS) decrease in the first hour by 2 or more). METHODS: Search of the US National Library of Medicine, National Institutes of Health (www.pubmed.gov), SCOPUS database (www.scopus.com) and Web of Science database (www.webofknowledge.com) using the key words 'labour' and 'remifentanil'. 44 identified articles were included in the review and 15 published randomised controlled studies were incorporated into the meta-analysis. This was based on the fixed model and described by differences in the VAS between t=0 and t=1 hour after remifentanil administration using the 95% confidence interval (CI). The analysis was computed using the Comprehensive meta-analysis version 2.2.064. RESULTS: The combined data from the meta-analysis showed a statistically significant decrease in VAS in the remifentanil group. From a comparison of the CIs of summary estimates with a cut-off decrease of VAS 2, for the fixed model, there was a statistically significantly greater decrease in VAS than the cut-off. In the systematic review, we describe possible modes of application, dosage and side-effects for mother, fetus/ newborn. CONCLUSION: The meta-analysis presented here confirms that remifentanil for labour analgesia is effective but questions remain which can only be answered by further randomized trials.
File Format	HTM / HTML
ISSN	12138118
Journal	Biomedical Papers
Issue Number	1
Volume Number	160
Language	English
Publisher	Vydavatelství Univerzity Palackého
Publisher Date	2016-03-01
Publisher Place	Czech Republic
Access Restriction	Open
Subject Keyword	Discipline Medicine
Content Type	Text
Resource Type	Article
Subject	Medicine Biochemistry, Genetics and Molecular Biology

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in