Background: Intravenous remifentanil may be the preferred analgesic when regional techniques are contraindicated.
Objective: To perform a systematic review on the use of remifentanil for analgesia in labor.
Methods: We searched MEDLINE (January 1995-August 2007) for studies on obstetric analgesia with remifentanil.
Results: We found 32 references representing the use of remifentanil in 257 women in labor. In most cases, patients reported relief of pain and a high level of satisfaction, with no severe side effects in mothers or neonates. When compared with meperidine and nitrous oxide in clinical trials, remifentanil provided better analgesia with fewer adverse effects.
Conclusion: Analgesia with intravenous remifentanil is more effective and safer than other alternatives to regional analgesic techniques in obstetrics. Nevertheless, the optimum system for infusing the drug must b e established and further studies of maternal and fetal safety should be carried out.