Remifentanyl

Remifentanil Information card

Remifentanil (Morphine Pump) During Childbirth - What You Need to Know

How does Remifentanil work?

Remifentanil is a short-acting and powerful painkiller (analgesic) which lasts about 3-5 minutes. The drug is eliminated quickly from the body when you stop using it. You will be given Remifentanil via an intravenous infusion (IV) with a pump. You will be able to control your own pain relief by pressing a button. When you press the button, the medicine will enter your body through the IV. The pump is configured in such a way that you will be unable to give yourself an overdose. Once you have administered yourself with the maximum dose, the pump will stop the Remifentanil infusion. Remifentanil will be stopped when you need to start pushing.

Advantages of Remifentanil

• it has a short and powerful painkilling effect and is quickly eliminated from the body
• it works quickly after administration
• it can be used throughout the dilation stage.
• it can be self-administered: you can ease the pain with the push of a button

Disadvantages of Remifentanil?

Remifentanil has been used in surgery for years. Remifentanil has also been used during labour in the Netherlands since 2005 – although it is not officially registered for this application. It is unknown whether it has any long-term consequences on the child.

• monitoring equipment is required: IV, oxygen monitoring, blood pressure monitoring and electronic foetal monitoring (EFM) for the baby. This all requires significant preparation time.
• its efficacy decreases after 4 to 6 hours of use
• Remifentanil has side effects such as nausea, itching and drowsiness.
• You must not walk during use
• Remifentanil may cause breathing problems, breathing may become slower or shallower (rare: respiratory arrest)

About 13% of women experience insufficient pain relief using Remifentanil and request an epidural anyway

What checks are needed if you use Remifentanil?

If you use Remifentanil, the nurse or midwife will check whether your breathing is sufficient. The oxygen level in your blood will be measured using a clip on your finger. Your heart rate and blood pressure will also be monitored regularly. If it seems that you are finding it harder to breathe, Remifentanil will be stopped. The chance that you will stop breathing altogether is very slim. If this does happen, however, the midwife or nurse will help you breathe. Because Remifentanil wears off after a couple of minutes, your body will quickly start breathing again of its own volition. A doctor or midwife will stay in the room to monitor you for the first half an hour after the medication is started and a nurse will stay in the room with you for half an hour thereafter.