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Alternative to pethidine could halve rate of epidurals

BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3495 (Published 14 August 2018) Cite this as: BMJ 2018;362:k3495
  1. Jacqui Wise
  1. London

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.

The …

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