Alternative to pethidine could halve rate of epiduralsBMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3495 (Published 14 August 2018) Cite this as: BMJ 2018;362:k3495
- Jacqui Wise
Using remifentanil instead of pethidine to relieve pain during labour could halve the number of women needing an epidural, a randomised controlled trial has shown.1
About a third of women receiving pethidine for labour pain subsequently require an epidural, which increases the risk of instrumental vaginal delivery. Remifentanil is a potent synthetic opioid with a very rapid onset and ultrashort duration of action, but it is rarely used in UK practice.
The authors of the study, published in the Lancet, are calling for a change in national clinical guidelines to incorporate the more routine use of remifentanil.