Patient information leaflet on Remifentanil PCA for labour analgesia Remifentanil is a type of pain relief medicati o n that has been identified as a safe and effective option for use during labour in women who are unable to receive an epidural. Remifentanil is a n ultra - short acting synthetic opioid, with a rapid onset of action. Remifentanil has a substantial body of evidence that supports its use for labour analgesia and is efficiently metabolised by both mother and baby . Such qualities make it ideal for use as a patient controlled analgesia in labour especially when epidural is contra indicated. It is important to inform you that this is an unlicensed use of this medication. This does not mean that the medication is unsafe - Remifentanil PCA is used routinely for pain relief in labour outside the terms of its UK li cense in many centres across the UK for many years. Setting up for Remifentanil PCA • Information leaflet regarding Remife nta nil PCA received and read. • 1 in 10 women will experience low oxygen saturation levels requiring oxygen supplementation via Oxygen mask or nasal cannula. • A dedicated intravenous cannula in place. • Full monitoring including CTG, Pulse oximeter, ECG and blood pressure • A PCA pump with drug and giving set to be set up by professional s like anaesthetist, midwife and ODPs. • You have a button to press to give yourself the Remifentanil. • It is important that only you press the button and no one else • The machine has a safety mechanism. It will only give one dose every 2 minutes, when you press the button. Advantages of Remifentanil PCA; • It works very quickly to provide you pain relief during labour. • It is removed by the body very quickly, so it has very few side effects for you and your baby. • Breast feeding can be done at the earliest opportunity. • You are in control of your pain relief. • If you had any opioids like Diamorphine or pethidine during labour, you will need to wait for 4 HOURS before you can have Remifentanil PCA for labour analgesia. • Could be an option to consider if ep idural is contra - indicated. Risks associated with Remifentanil PCA ; Risks Mother Baby Drowsiness +++ - Itching ++ - Sickness ++ - Respiratory rate <8/min ++ - Further Information Th e Anaesthetist on delivery Suite will happily discuss Remifentanil PCA with you when you arrive and answer any questions you may have