Remifentanil em analgesia para o trabalho de parto

Eliane C S Soares; Michelle R Lucena; Renata C Ribeiro; Letícia L Rocha; Walkíria W Vilas Boas

doi:10.1590/S0034-70942010000300013

Review Article

Remifentanil em analgesia para o trabalho de parto

Remifentanil as analgesia for labor

Eliane C S Soares; Michelle R Lucena; Renata C Ribeiro; Letícia L Rocha; Walkíria W Vilas Boas

http://dx.doi.org/10.1590/S0034-70942010000300013 Braz J Anesthesiol, vol.60, n3, p.334-346, 2010

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Resumo

JUSTIFICATIVA E OBJETIVOS: As técnicas neuroaxiais representam atualmente os métodos mais efetivos para controle da dor durante o trabalho de parto e a analgesia peridural utilizando soluções anestésicas ultradiluídas é considerada o padrão ouro, promovendo alívio adequado da dor com mínimos efeitos colaterais. Em algumas situações, no entanto, o emprego dessas técnicas é limitado pela existência de contraindicações maternas ou obstáculos estruturais e materiais. Nestes casos, as opções alternativas ainda são precárias e escassas, oferecendo resultados pouco otimistas e de eficácia questionável. CONTEÚDO: Este artigo apresenta, com base em uma revisão da literatura, as informações disponíveis relacionadas ao emprego do remifentanil como técnica alternativa para a analgesia de parto discutindo aspectos farmacocinéticos, farmacodinâmicos, eficácia analgésica, satisfação materna e efeitos colaterais maternos e fetais. CONCLUSÕES: Os dados iniciais apontam o remifentanil como uma opção promissora a ser empregada nas situações em que a gestante não quer ou não pode receber a analgesia neuroaxial.

Palavras-chave

ANALGÉSICOS, ANALGÉSICOS, ANALGESIA

Abstract

BACKGROUND AND OBJECTIVES: The neuraxial techniques currently represent the most effective methods for pain control during labor and the epidural block using ultradiluted anesthetic solutions is considered the gold standard promoting adequate pain relief with minimum side effects. In some situations however the use of these techniques is limited by the existence of maternal contraindications, or structural or material obstacles. In these cases, the alternatives are still precarious and scarce offering little optimistic results and of dubious effectiveness. CONTENT: This article presents through a literature review the available information on the use of remifentanil as an alternative technique for analgesia during labor discussing aspects of pharmacokinetics, analgesia efficacy, maternal satisfaction and maternal/fetal side effects. CONCLUSIONS: The initial data show that remifentanil is a promising option to be employed in situations where the parturient cannot or does not want to receive the neuraxial analgesia.

Keywords

ANALGESIA, ANALGESIA, ANALGESIA

References

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Remifentanil em analgesia para o trabalho de parto

Remifentanil as analgesia for labor

Eliane C S Soares; Michelle R Lucena; Renata C Ribeiro; Letícia L Rocha; Walkíria W Vilas Boas

Resumo

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Abstract

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