Remifentanil or an Epidural

[Starlight85]

Has anyone had Remifentanil or an Epidural during labour? What were your experiences of both? Would you recommend one over the other?

I don't know much about Remifentanil but like the idea that it is short acting.

I am interested in this. Had epidurals with both labours, induced both times. Told anaesthetist I want to try and do it without this time as I want a more active labour. He suggested remifentanil. Haven't heard much about it though?

Epidural. But ask anaesthetist for their expert advice.

I've had 3 babies in the last 3 years and had remi with each of them.

I wouldn't have an epidural - I don't want to be fixed in one position

I got the hospital well dilated with each one and had remi just to take the edge off. What I like is that it has a very short half life. So I stopped administering it during the pushing stage and it wore off basically right away. I had 3 natural deliveries. First one assisted and ultimately needed a spinal block for that due to malpositioned baby. Last 2 babies were natural deliveries. Second baby no stitches and third baby 2 stitches. I gave birth both times meaning over the back of the bed. Would never have been able to get into that position if I'd had an epidural (or felt like that was the natural position)

I really rate it and have 2 friends who are consultant anaesthetists. One had it during her labour and the other recommended it to his wife

I was offered remifentanil as the epidural didn't agree with me with my first baby. In the end there was no time for it but I think the anaesthesiologist said I'd need to be on oxygen with it.

You need your oxygen levels monitored which they do via the clip on your finger as remi is also
a sedative. But you don't need oxygen administered to have it, unless there was some other underlying issue. But if respiration was an issue, I don't think they would give it due to the sedation issue

Ah maybe that was it then.

Ohhh I have never heard of this, going to look it up now but sounds good! Does it block as much pain as an epidural?

I had the remi with my 2nd- not many hospitals offer it, compared with my first birth where I had gas and air only it was absolutely amazing. Contractions went from excruciating to absolutely bearable.

I was a bit away with the fairies but in a good way, I still remember everything. Think I was a bit giggly too, according to DH in a much better mood than previously!

It wears off very quickly which is good if you don't like it (you give yourself a shot every contraction and it will wear off completely within 3/4 contractions). Only thing is I remember realising that I was a bit too "out of it" to concentrate on pushing, so when it was time to push I stopped it (my decision) and actually pushed him out with gas and air only. So by the time he was born it had completely worn off.

Yeah I didn't have oxygen but I was closely monitored, like an epidural you have to be in a consultant-led unit rather than MLU.

Remi isn't offered much at the hospital I work at. It's an incredibly potent opioid (drug related to morphie), that has a short on and off set, but comes with its own set of complications.

Round our way, the only way you would "qualify" for it is if there was a medical reason you couldn't have an epidural - like blood clotting problems or significant spinal surgery.

Speak to your midwife/obstetrician to see if it is offered round your way first before getting your heart set on it.

www.uhs.nhs.uk/Media/Controlleddocuments/Patientinformation/Pregnancyandbirth/Pain-relief-in-labour-epidurals-and-remifentanil-patient-information.pdf

^not my hospital but worth reading