Remifentanil vs. epidural analgesia for the management of acute pain associated with labour. Systematic review and meta-analysis☆

Abstract Introduction Remifentanil has an attractive pharmacological profile for use in obstetric analgesia as a technique for mass application, with similar benefits and satisfaction as epidural analgesia. Objective To assess the efficacy, equivalence and safety of remifentanil vs. epidural analgesia in obstetrics. Methods Systematic review and meta-analysis of clinical trials using the Cochrane methodology. Results No equivalence was found in relation to epidural analgesia; however, efficacy was found in the remifentanil group at different time points during the evaluation. The incidence of adverse effects was similar in the two groups, except for nausea. Conclusions Remifentanil is not equivalent to epidural analgesia but could certainly decrease the intensity of pain.