What do systematic reviews say?

Remifentanil (PCA) vs another opioid (PCA)

Remifentanil (PCA) showed no clear difference in additional analgesia required (escape analgesia) compared with another opioid (PCA) (low certainty).

• Patient‐controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour 2017 · Cochrane Headline outcomes only
  RR 0.76 [0.45, 1.28]
  3 studies · 215 participants
  Low

Remifentanil (PCA) vs remifentanil (continuous IV)

• Patient‐controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour 2017 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 59 participants
  Very low

Remifentanil (PCA) vs another opioid (IV/IM)

Remifentanil (PCA) probably leads to lower additional analgesia required (escape analgesia) compared with another opioid (IV/IM) (moderate certainty).

• Patient‐controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour 2017 · Cochrane Headline outcomes only
  RR 0.57 [0.4, 0.81]
  3 studies · 190 participants
  Moderate

Remifentanil (PCA, increasing bolus dose) vs remifentanil (PCA, increasing infusion dose)

• Patient‐controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour 2017 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 20 participants
  Low