Continuous intravenous infusion of remifentanil improves the experience of parturient undergoing repeat cesarean section under epidural anesthesia

Abstract Background: To observe the effects of intravenous remifentanil on maternal comfort, maternal and neonatal safety during repeat cesarean section under epidural anesthesia. Methods: A total of 80 parturient undergoing repeat cesarean section were involved in the study. The patients were randomly divided into the intravenous remifentanil-assisted epidural group (group R) and epidural group (group E), respectively (n=40). In group R, the remifentanil was continuously intravenously infused as an adjuvant to epidural anesthesia. In group E, 0.75% ropivacaine epidural or intravenous ketamine was administered as needed. Parturient baseline characteristics, vital signs, VAS scores, and comfort scores during surgery were recorded. Adverse effects were also recorded. Results: A total of 80 patients were enrolled in the current study and the final analyses included 39 patients in group R and 38 patients in group E. No differences in patients’ baseline characteristics were found between the two groups (p > 0.05). Compared with group E, the comfort score was significantly higher in group R (9.1±1.0 vs. 7.5±1.3, p<0.001), whereas the maximum VAS score was significantly lower in group R (1.8±1.2 vs. 4.0±0.9, p<0.001). Maternal and neonatal adverse effects did not differ between the two groups during surgery (p>0.05). Conclusions: Continuous intravenous infusion of low-dose remifentanil can significantly improve the experience of parturients undergoing repeat cesarean section under epidural anesthesia, without obvious maternal or neonatal adverse effects. Keywords: Remifentanil; Epidural anesthesia; Repeat cesarean delivery