What do systematic reviews say?

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
  4 studies · 216 participants
  Very low

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 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 another opioid (PCA)

• 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 (PCA)

• 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 (PCA)

• Patient‐controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour 2017 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 17 participants
  Very low

Remifentanil (PCA) vs epidural/CSE

• Patient‐controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour 2017 · Cochrane Headline outcomes only
  no estimate extracted
  7 studies · 2135 participants
  Very low

Remifentanil (PCA) vs epidural/CSE

• Patient‐controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour 2017 · Cochrane Headline outcomes only
  no estimate extracted
  6 studies · 235 participants
  Low

Remifentanil (PCA) vs epidural/CSE

Remifentanil (PCA) probably leads to higher additional analgesia required 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 9.27 [3.73, 23.03]
  6 studies · 1037 participants
  Moderate

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 epidural/CSE

• Patient‐controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour 2017 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 38 participants
  Very 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
  3 studies · 180 participants
  Very low

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 epidural/CSE

Remifentanil (PCA) showed no clear difference in apgar score ≤ 7 (< 7) at 5 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 1.26 [0.62, 2.57]
  5 studies · 1322 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
  0 studies · 0 participants
  GRADE not reported

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 · 53 participants
  Very 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 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 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 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