Labor analgesia is an essential health caring procedure for women. However, epidural analgesia cannot be performed on all subjects for different contraindications, such as lower platelet counter, back infection at the puncture site, and fear of epidural injection etc. Therefore, intravenous analgesia is an alternative for such conditions. Given the influence of intravenous administration of drugs on fetus, the drug selection is very important. Remifentanil, a super-short efficacious opioid, can last for 3-4 minutes after injection, which is similar in both maternal and fetal environment. Thus the fetus-associated side effects would be less than other drugs. The investigators hypothesized that remifentanil would be a superior intravenous drug used with patient-controlled technique for labor analgesia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
1,000
Intravenous administration of hydromorphone 1mg at the patient's request if they felt uterine contraction pain
Remifentanil intravenous PCA: 0.2μg/kg, lockout time interval 2 minutes, continuous infusion rate 0.2-0.8μg/kg/min.
Nanjing Maternal and Child Health Care Hospital
Nanjing, Jiangsu, China
Maternal Visual Analog Scale (VAS) rating of pain
Time frame: Prior to analgesia, latent phrase, active phrase, second stage of labor, posterior to vaginal delivery
Rate of cesarean delivery
Time frame: Analgesia initiation (0 min) to successful vaginal delivery (this time period underwent changing in different individuals)
Rate of instrument-assisted delivery
Time frame: Analgesia initiation (0 min) to successful vaginal delivery (this time period underwent changing in different individuals)
Indications of cesarean delivery
Time frame: Analgesia initiation (0 min) to cesarean section (this time period underwent changing in different individuals)
Duration of analgesia
Time frame: Initiation of analgesia (0 min) to the disappearance of sensory block (this time period underwent changing in different individuals)
Maternal satisfaction with analgesia
Time frame: At the end of the vaginal delivery (this time period underwent changing in different individuals)
Maternal oral temperature
Time frame: Analgesia initiation (0 min) to successful vaginal delivery (this time period underwent changing in different individuals)
Use of oxytocin after analgesia
Time frame: Analgesia initiation (0 min) to successful vaginal delivery (this time period underwent changing in different individuals)
Maximal oxytocin dose
Time frame: At the end of vaginal delivery (this time period underwent changing in different individuals)
Breastfeeding success at 6 weeks after vaginal delivery
Time frame: At the sixth week after successful delivery
Neonatal one-minute Apgar scale
Time frame: At the first minute of baby was born
Neonatal five-minute Apgar scale
Time frame: At the fifth minute of baby was born
Umbilical-cord gases analysis
Time frame: At the time baby was born (0 min)
Neonatal sepsis evaluation
Time frame: After the baby was born (15 min after delivery)
Neonatal antibiotic treatment
Time frame: After the baby was born (one day after delivery)
Incidence of maternal side effects
Time frame: Analgesia initiation (0 min) to successful vaginal delivery (this time period underwent changing in different individuals)
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