What do systematic reviews say?

Remifentanil (PCA) vs epidural/CSE

Remifentanil (PCA) showed no clear difference in maternal respiratory depression (< 9, < 8 breaths/min) compared with epidural/CSE (low certainty).

• Patient‐controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour 2017 · Cochrane Headline outcomes only
  RR 0.91 [0.51, 1.62]
  3 studies · 687 participants
  Low

Remifentanil (PCA) vs remifentanil (continuous IV)

Remifentanil (PCA) may leads to lower maternal respiratory depression (< 8 breaths/min) compared with remifentanil (continuous IV) (low certainty).

• Patient‐controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour 2017 · Cochrane Headline outcomes only
  RR 0.98
  2 studies · 135 participants
  Low

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

• Patient‐controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour 2017 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 36 participants
  Very low

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
  0 studies · 0 participants
  GRADE not reported