Determination of adequacy of analgesia and satisfaction of vaginal delivery women with persistent intravenous analgesia with remifentanil infusion and comparing it with epidural analgesia

Abstract

Due to the different results according to various studies in the field of pain control during vaginal delivery and most gynecologists and midwives and patients are more demanding less invasive methods and on the other hand Al-Zahra Educational and Medical Center ) Which is a referral center for high-risk and problematic deliveries with various underlying diseases that make it difficult to perform neuroaxial procedures, due to the large number of patients referred to this center and patients' beliefs about low back pain. Patients' dissatisfaction with epidural analgesia, so we designed this study to use the intravenous infusion of remifentanil to induce labor analgesia and the results in terms of pain relief, patient satisfaction and its effects on Examine the mother and fetus so that if the desired results are achieved, this method can be used as an alternative to neuroaxial analgesia in cases where it is not possible to do it with more ease, so that gradually the ground for accepting labor with analgesia for obstetricians and Our patients who always want Yarns provide labor pain relief with complete confidence and safety. Materials and Methods This study is a randomized clinical trial that was conducted during 1398 in Al-Zahra Hospital (affiliated to Abom Medical University of Tabriz). Sixty patients were enrolled in the study using the available method and were randomly divided into two groups of remifentanil and epidural using a table of random numbers; Pain, hemodynamic status and satisfaction of postpartum pregnant women were compared. Data were analyzed using ANOVA and t-test in SPSS22 software. P value less than 0.05 was considered significant. Results: Maternal severity was reduced in both groups, but there was no difference between the two methods; Complications of maternal nausea - vomiting and pruritus were significantly higher in patients with persistent epidural analgesia than in patients with persistent intravenous analgesia with remifentanil. Compared to other possible complications (maternal respiratory depression, changes in blood pressure and changes in maternal heart rate), we did not observe a statistically significant difference between the groups. There was no statistically significant difference in terms of Apgar score of newborns born in 1 minute between the two groups. There was no statistically significant difference in terms of maternal satisfaction in any of the measured items of satisfaction between the two groups.