Remifentanil in Childbirth: What You Need to Know

At Verloskundigen PuurBegin we believe in a birth that suits your wishes and needs. Pain management is an important part of this process, and Remifentanil is one of the options you can consider. But what exactly is Remifentanil? How does it work, and what are the pros and cons? In this article we will take you through everything you need to know about this form of pain relief during childbirth.

Who decides whether you are eligible for Remifentanil?

The choice for Remifentanil is always made in consultation with your midwife or gynaecologist. They will assess whether this form of pain relief is suitable for your situation. Factors that play a role in this include the progress of the delivery, your medical history and any allergies. The condition of your baby is also taken into account. Remifentanil is only available in the hospital, so if you give birth at home, this is not an option.

Who is Remifentanil suitable for?

Remifentanil is a good choice for women who need strong pain relief during labor, but still want to maintain as much control as possible. For example, it is suitable if you do not want an epidural or if this is not possible for medical reasons. Remifentanil can also be a solution if you have been in labor for a long time and the pain is difficult to tolerate.

How does Remifentanil work?

Remifentanil is a powerful painkiller from the group of opioids. It is administered via an infusion pump, which you can operate yourself. This is called PCA (Patient Controlled Analgesia). You will be given a button with which you can administer a small dose yourself when you need it. The drug works within one minute and has a short duration of action, so that you quickly regain control over your body.

Remifentanil works by blocking the pain signals in your brain. This makes you feel less pain, but you remain alert and involved in the birth.

How do you get Remifentanil?

If you choose Remifentanil, an IV needle will be placed in your arm. A pump will be connected to this, which will administer the medication. You will be given an explanation of how the button works and how many times you can press it. The system is set up so that you can never administer too much, which guarantees safety.

During the administration, your condition and that of your baby will be continuously monitored. This is done via a CTG device, which monitors your baby's heart rate and your contractions.

Benefits of Remifentanil

1. Fast acting: Within one minute you will feel relief from the pain.
2. Self-control: You decide when you need a dose.
3. Short duration of action: The drug disappears quickly from your body, so you will soon be clear-headed again.
4. No restriction in movement: Unlike an epidural, you can still change positions.
5. Less chance of medical intervention: Remifentanil has less effect on the progress of labour than some other types of pain relief.

Disadvantages of Remifentanil

Although Remifentanil has many advantages, there are also some disadvantages that you should be aware of. These can be divided into disadvantages for the mother and possible effects on the baby.

Disadvantages for the mother

• Drowsiness: Remifentanil can cause drowsiness, making you less alert.
• Nausea: Some women experience nausea or vomiting.
• Itch: Opioids can cause itching, especially on the face and chest.
• Respiratory inhibition: In rare cases, Remifentanil can slow down your breathing (see below).

Effect on the baby

Remifentanil can pass through the placenta to your baby. This can temporarily affect your baby's breathing and heart rate. That's why your baby will be monitored closely after birth. Fortunately, the drug quickly disappears from your baby's body, so long-term effects are rare.

Influence on breathing

One of the most important points of attention with Remifentanil is the possible effect on your breathing. The drug can cause your breathing to temporarily slow down or become less deep. That is why you are continuously monitored during administration. The infusion pump is set so that you can never administer too much, which reduces the risk of breathing problems reduces.

Side effects

In addition to the disadvantages mentioned above, there are some side effects that can occur when using Remifentanil:

• Dizziness: Some women feel light-headed.
• Decreased blood pressureThis may cause you to feel light-headed or faint.
• Headache: A common side effect of opioids.
• Difficulty urinating: Remifentanil may temporarily affect bladder function.

These side effects are usually mild and disappear quickly after stopping the medication.

Conclusion

Remifentanil is an effective and safe option for pain relief during labor, if properly supervised. It offers the opportunity to maintain control over your pain, while still experiencing powerful relief. However, it is important to be well informed about the pros and cons, so that you can make a well-considered choice.

At Verloskundigen PuurBegin we are ready to guide you in this choice. Together we discuss what best suits your wishes and situation, so that you can confidently work towards a positive birth experience.

Want to know more about pain relief during labor? Contact Midwives PuurBegin or ask about our information sessions.

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Midwives PuurBegin
Address: Orkestlaan 148, 8265RC Kampen
Telephone: 085 40 19 095