What do systematic reviews say?

Remifentanil (PCA) vs another opioid (PCA)

It is very uncertain whether remifentanil (PCA) changes rate of caesarean delivery compared with another opioid (PCA) (very low certainty).

• Patient‐controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour 2017 · Cochrane Headline outcomes only
  RR 2.78 [0.99, 7.82]
  2 studies · 143 participants
  Very low

Remifentanil (PCA) vs epidural/CSE

Remifentanil (PCA) showed no clear difference in rate of caesarean delivery compared with epidural/CSE (moderate certainty).

• Patient‐controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour 2017 · Cochrane Headline outcomes only
  RR 1 [0.82, 1.22]
  9 studies · 1578 participants
  Moderate

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
  0 studies · 0 participants
  GRADE not reported

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

Remifentanil (PCA) showed no clear difference in rate of caesarean delivery compared with another opioid (IV/IM) (low certainty).

• Patient‐controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour 2017 · Cochrane Headline outcomes only
  RR 0.63 [0.3, 1.32]
  4 studies · 215 participants
  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
  1 study · 20 participants
  Low