Úspěšné podání naloxonu v průběhu srdeční zástavy při porodní analgezii remifentanilem: kazuistika a retrospektivní audit

Title in English Successful reversal of cardiac arrest in the course of remifentanil obstetric analgesia using naloxone: Case report and retrospective audit


Year of publication 2017
Type Article in Periodical
Magazine / Source Anesteziologie & intenzivní medicína
MU Faculty or unit

Faculty of Medicine

Field Other medical specializations
Keywords remifentanil; labour analgesia; patient controlled analgesia; cardiac arrest; peripartum resuscitation
Description Study objective: The aim of this article is to highlight the rare serious complication of labour analgesia with remifentanil, describe its solution and provide an overview of the efficacy and safety of remifentanil in 2012-2014 in the hospital, where the use of remifentanil in childbirth is a the analgesic method of choice. Study design: Case report and retrospective audit. Setting: Regional Hospital. Material and methods: With the approval of the Ethics Committee Karlovy Vary Regional Hospital we aimed to enroll parturients who laboured in the Sokolov Hospital and their labour pain was relieved with remifentanil. The objective was to verify whether the application of labour analgesia with remifentanil will decrease pain intensity by 2 or more based on the visual analogue scale. Maternal satisfaction with the analgesic method was evaluated by five-percentile range. All complications associated with the analgesia were recorded. Results: We enrolled 66 parturients (13-39 years) in the period 2012-2014. There was a statistically significant difference in pain intensity after the remifentanil administration (decrease VAS 2, p = 0.006). Satisfaction with the analgesic method was 82.4%. Except of described case report of cardiac arrest with successful administration of naloxone during resuscitation, there were no serious complications associated with the application of remifentanil labour analgesia. Conclusion: Introduced regimen of obstetric analgesia with remifentanil led to the reduction in the intensity of labour pain at a high rate of maternal satisfaction. Case report pointed out the need for availability of remifentanil antidote in the delivery room and on the importance of rapid availability of anaesthesia team.

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