Findings

What do systematic reviews say?

91 questions · 91 findings · 2 reviews · Pregnancy and Childbirth

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No studies found 2 · 2.2%GRADE not reported 10 · 11%Very low 42 · 46.2%Low 30 · 33%Moderate 4 · 4.4%High 3 · 3.3%

Remifentanil (PCA) vs another opioid (PCA)

Maternal respiratory depression (< 8 breaths/min) · women in labour with planned vaginal delivery

1 finding from 1 review

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)

Low Apgar score · women in labour with planned vaginal delivery

1 finding from 1 review

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

Satisfaction with pain relief · women in labour with planned vaginal delivery

1 finding from 1 review

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‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · women in labour with planned vaginal delivery

1 finding from 1 review

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

Additional analgesia required (escape analgesia) · women in labour with planned vaginal delivery

Remifentanil (PCA) probably leads to higher additional analgesia required compared with epidural/CSE (moderate certainty).

1 finding from 1 review

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

Caesarean section · women in labour with planned vaginal delivery

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

1 finding from 1 review

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

Maternal apnoea · women in labour with planned vaginal delivery

1 finding from 1 review

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)

Pain intensity VAS (0 to 100; 0 = no pain, 100 = worst pain) · women in labour with planned vaginal delivery

1 finding from 1 review

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

Maternal respiratory depression (< 9, < 8 breaths/min) · women in labour with planned vaginal delivery

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

1 finding from 1 review

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

Low Apgar score · women in labour with planned vaginal delivery

Remifentanil (PCA) showed no clear difference in apgar score ≤ 7 (< 7) at 5 min compared with epidural/CSE (low certainty).

1 finding from 1 review

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)

Satisfaction with pain relief · women in labour with planned vaginal delivery

1 finding from 1 review

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)

Pain intensity VAS (0 to 100; 0 = no pain, 100 = worst pain) · women in labour with planned vaginal delivery

1 finding from 1 review

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)

Additional analgesia required (escape analgesia) · women in labour with planned vaginal delivery

1 finding from 1 review

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)

Caesarean section · women in labour with planned vaginal delivery

1 finding from 1 review

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)

Maternal apnoea · women in labour with planned vaginal delivery

1 finding from 1 review

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)

Maternal respiratory depression (< 8 breaths/min) · women in labour with planned vaginal delivery

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

1 finding from 1 review

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 remifentanil (continuous IV)

Apgar score less than 7 at 5 minutes · women in labour with planned vaginal delivery

1 finding from 1 review

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

Satisfaction with pain relief · women in labour with planned vaginal delivery

1 finding from 1 review

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

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

Additional analgesia required (escape analgesia) · women in labour with planned vaginal delivery

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

1 finding from 1 review

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)

Reduction in pain intensity · women in labour with planned vaginal delivery

1 finding from 1 review

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