Analgesic effectiveness of remifentanil intravenous patient-controlled regimen in different stages of labor analgesia

Objective To investigate the effectiveness and safety of intravenous remifentanil patient-controlled intravenous analgesia (PCIA) regimen during the active and latency period of the first labor and its influence on plasma prostaglandin E2 (PGE2) in parturients. Methods A total of 60 full-term parturients with a single fetus giving birth vaginally in our center from January 2021 to February 2022 were enrolled in this study. The patients who were willing to receive remifentanil intravenous controlled analgesia formed group R (n=30), and those who refused analgesia formed group C (n=30). Group R received PCA of remifentanil (continuous background infusion of 0.03 μg/kg·min and bolus doses of 0.3 μg/kg with 2 min lockout period in latent phase; continuous background infusion of 0.05 μg/kg·min and bolus doses of 0.4 μg/kg with 2 min lockout period in active phase). Maternal pain score, sedation efficacy, satisfaction, and maternal and fetal adverse reactions were recorded. Neonatal Apgar score and the results of umbilical arterial blood gas analysis were recorded. The levels of PGE2 in R group were determined before and after analgesia. Results Compared to Group C, the mean NRS pain score and the lowest pain score of Group R in latent and active phases were significantly lower (P < 0.05). The overall sedation score and satisfaction score of Group R were obviously higher when compared with Group C (P < 0.05). The incidences of dizziness and drowsiness were statistically higher in the Group R (P < 0.05). No differences were seen in the neonatal Apgar score and the results of umbilical arterial blood gas analysis between the 2 groups (P>0.05). The serum PGE2 levels had no obvious change in Group R before and after analgesia (P>0.05). Conclusion According to the different intensities of labor pain in latent and active phase, appropriate adjustment of remifentanil intravenous controlled analgesia regimen can obviously mitigate maternal labor pain, without obvious maternal and fetal adverse reactions, and has no influence on maternal PGE2 levels.