Anyone have experience with remifentanil?

[Penguinandminipenguin]

Just met two anesthetists who confirmed I can't have a spinal or epidural, so they've offered this to me as pain relief.

They've explained what it does, that it's patient controlled and I would press it with each contraction and that it's short lasting, doesn't cross the placenta as much as pethidine etc. I just wanted to hear other people's experiences about it though. Did you find it worked for you? Were there any side effects?

TIA :)

[SlipperyLizard]

I had it with DD1. It was very effective in that if I pressed the button at the right time I didn't know I had had a contraction. However, it left me so zonked that I couldn't press the button at the right moment! Thankfully due to high bp I was on the monitor, so DH could see the contractions building and give me a prod.

I had to stop using it for the pushing, as it (and even gas and air for me, which I also had and hated) were incompatible with doing anything that needed focus! It did make me feel a bit dizzy/queasy - a bit like the feeling you get when you've drunk too much alcohol too quickly and then it all hits you.

All drugs affect different people in different ways, so your experience could be very different. The good thing is if you don't like it you can stop, and it is quickly out of your bloodstream. As an alternative to pethidine it worked for me (I haven't had pethidine but if it had a similar effect but without the ability to stop I would have hated it). I didn't want an epidural (but ended up with spinal for placenta removal) and it helped me not need one for labour (as did a 6 hour labour).

With DD2 I really wasn't sure what to do in labour, whether to have it again. In the end I managed on gas and air because it was a very quick labour (2 hours from first twinge to delivery). Still hated the gas and air as much as the first time, and some people rave about that!

[Penguinandminipenguin]

Thank you very much for the reply :) It's really interesting to hear someone's experience with it, as there doesn't seem to be that much online about it really. I'll be on a monitor too, due to being high risk so if I do feel out of it, I'll make sure I tell dh to let me know when I need to be pressing the button!

[PeppermintInfusion]

I had it, my friend who is an anaethetist recommended it when I asked her about pain relief. I wouldn't rule out using it again as it was effective though I did feel a bit out of it. DH said I would be talking to Mw and then sort of trailOff and zone out for a bit. It did take a few goes to press the button at the right time and probably not the best for an active birth, but as you'll be monitored anyway that won't matter as much.
I recovered quickly after birth and was up, about and showered before I even got to the ward, which is what would put me off going for an epidural as you'd be in bed immobile for longer. The only con for me was that you have to stop taking it when pushing, so after several hours it was a rude awakening when I snapped out of my drowsiness. You can use it again though afterwards if you get after pains/stitches/etc.

[MissDuke]

I haven't used it, but have looked after many women that have. It is very popular in my hospital, and personally I had planned to use it if I needed stronger pain relief rather than opt for an epidural. It is much less invasive and after the birth you can just get up and about, unlike with an epidural. It also doesn't relax the pelvic floor like an epidural does and so isn't linked to increased risk of instrumental delivery. You can still use the gas and air with it if you need to. It can make you a bit sick or itchy but they can give you something for that, it can also make you breathe less deeply which sounds a bit scary but its honestly fine - they monitor your oxygen saturation levels and give you oxygen if needed. It is considered to be very safe.

[Wolpertinger]

While it can make you a bit sick, it is far far better for that than pethidine which is generally described by anaesthetists as a vomit inducer with mild analgesic properties.

[MissDuke]

Yeh pethidine isn't used at all now in my trust, just diamorph which supposedly has less unpleasant side effects