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Remifentanil analgesia during external cephalic version for breech presentation in nulliparous women at term: A randomized controlled trial

BACKGROUND: The aim of the study was to assess the efficacy and safety of remifentanil for pain relief during external cephalic version (ECV) for breech presentation in nulliparous women at term. METHODS: A total of 144 nulliparous women with singleton breech presentation were randomly divided into...

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Autores principales: Wang, Zhi-Hong, Yang, Yi, Xu, Gui-Ping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369890/
https://www.ncbi.nlm.nih.gov/pubmed/28296735
http://dx.doi.org/10.1097/MD.0000000000006256
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author Wang, Zhi-Hong
Yang, Yi
Xu, Gui-Ping
author_facet Wang, Zhi-Hong
Yang, Yi
Xu, Gui-Ping
author_sort Wang, Zhi-Hong
collection PubMed
description BACKGROUND: The aim of the study was to assess the efficacy and safety of remifentanil for pain relief during external cephalic version (ECV) for breech presentation in nulliparous women at term. METHODS: A total of 144 nulliparous women with singleton breech presentation were randomly divided into the intervention group and the placebo group, with 72 subjects in each group. The subjects in the intervention group received remifentanil (infused at 0.1 μg kg(–1) min(–1) with demand boluses of 0.1 μg/kg), whereas those in the placebo group were given saline placebo. This study was conducted from May 2013 to April 2016. The outcomes measures include pain (measured with the visual analog scale, VAS), success rate of ECV, maternal satisfaction for ECV, and adverse events. RESULTS: A total of 137 participants completed the study. The intervention with remifentanil showed greater efficacy than did placebo in decreasing the VAS score immediately after ECV (intervention group 4.3 ± 2.2 vs placebo group 6.4 ± 2.5, P < 0.01). A significant difference in the ECV success rate was also found between the 2 groups (intervention group 56.9% vs placebo group 38.9%, P = 0.03). In addition, a significant difference in the satisfaction score was also detected (intervention group 9.3 ± 0.9 vs placebo group 6.7 ± 1.2, P < 0.01). The observed adverse events were similar between the 2 groups. CONCLUSION: This study shows that remifentanil could decrease pain, improve the ECV success rate, and improve satisfaction in nulliparous women at term during the period of ECV. Furthermore, it is also well tolerated with few adverse events.
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spelling pubmed-53698902017-03-31 Remifentanil analgesia during external cephalic version for breech presentation in nulliparous women at term: A randomized controlled trial Wang, Zhi-Hong Yang, Yi Xu, Gui-Ping Medicine (Baltimore) 3700 BACKGROUND: The aim of the study was to assess the efficacy and safety of remifentanil for pain relief during external cephalic version (ECV) for breech presentation in nulliparous women at term. METHODS: A total of 144 nulliparous women with singleton breech presentation were randomly divided into the intervention group and the placebo group, with 72 subjects in each group. The subjects in the intervention group received remifentanil (infused at 0.1 μg kg(–1) min(–1) with demand boluses of 0.1 μg/kg), whereas those in the placebo group were given saline placebo. This study was conducted from May 2013 to April 2016. The outcomes measures include pain (measured with the visual analog scale, VAS), success rate of ECV, maternal satisfaction for ECV, and adverse events. RESULTS: A total of 137 participants completed the study. The intervention with remifentanil showed greater efficacy than did placebo in decreasing the VAS score immediately after ECV (intervention group 4.3 ± 2.2 vs placebo group 6.4 ± 2.5, P < 0.01). A significant difference in the ECV success rate was also found between the 2 groups (intervention group 56.9% vs placebo group 38.9%, P = 0.03). In addition, a significant difference in the satisfaction score was also detected (intervention group 9.3 ± 0.9 vs placebo group 6.7 ± 1.2, P < 0.01). The observed adverse events were similar between the 2 groups. CONCLUSION: This study shows that remifentanil could decrease pain, improve the ECV success rate, and improve satisfaction in nulliparous women at term during the period of ECV. Furthermore, it is also well tolerated with few adverse events. Wolters Kluwer Health 2017-03-24 /pmc/articles/PMC5369890/ /pubmed/28296735 http://dx.doi.org/10.1097/MD.0000000000006256 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle 3700
Wang, Zhi-Hong
Yang, Yi
Xu, Gui-Ping
Remifentanil analgesia during external cephalic version for breech presentation in nulliparous women at term: A randomized controlled trial
title Remifentanil analgesia during external cephalic version for breech presentation in nulliparous women at term: A randomized controlled trial
title_full Remifentanil analgesia during external cephalic version for breech presentation in nulliparous women at term: A randomized controlled trial
title_fullStr Remifentanil analgesia during external cephalic version for breech presentation in nulliparous women at term: A randomized controlled trial
title_full_unstemmed Remifentanil analgesia during external cephalic version for breech presentation in nulliparous women at term: A randomized controlled trial
title_short Remifentanil analgesia during external cephalic version for breech presentation in nulliparous women at term: A randomized controlled trial
title_sort remifentanil analgesia during external cephalic version for breech presentation in nulliparous women at term: a randomized controlled trial
topic 3700
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369890/
https://www.ncbi.nlm.nih.gov/pubmed/28296735
http://dx.doi.org/10.1097/MD.0000000000006256
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