remifentanil pca

[Anonforthis2121]

currently 35 weeks pregnant and now having to decide between a csection under general or an induction at 38 weeks where I will not be allowed an epidural. I have been told my option would be a pca drip with remifentanil and just wondering if anyone has had any experience before I make my mind up on what to do

I've had remi - it was a really really strange experience, memory loss etc but it's switched off for pushing. Much better than a general as you're in the room!

I'm not allowed epidurals either and I was induced on a drip 3 x times without a epidural for each one - I had a episiotomy as well - remi did the trick and you'll be glad you didn't opt for a general.

I had it with both my births- really worked for me.

I am not good with pain, but it alleviated the contractions without numbing the sensation of when to push.

Immediately post birth I was able to drag myself for a shower unassisted, and I was physically able to care for the babies overnight as opposed to being stuck in the bed waiting for an epidural to wear off.

I’m more worried about effects on baby and also the fact I have needed instrumental births and had pph which involved a lot of intervention.

I had it with both of mine (induced with syntocin both times)...it's the absolute bomb. Loved it. Vomited a bit the first time but could not have cared less, it was great.

"I'm more worried about effects on baby " Sadly but understandably, they confiscate the clicker when it's time to push (or in the case of #1, time for EMCS....#2 was VBAC), so the baby doesn't come out dozy and breathes properly. The effect wears off really quickly but you're in the home straight by then and you'll fly it.

remi does cross the placenta, but it's metabolism is very different to that of other opioids and it is cleared from the fetus very quickly too. We wouldn't be using it in labour if it was known to be problematic for the baby. (obs anaesthetist)

thank you

finding it very difficult to decide between the two if I’m honest especially if not during pushing as I pushed for 2-3 hours with two of my kids and they had 90th centile heads. I’m starting to sway to csection even though being asleep is absolutely terrifying to me too.

I'd maybe check what the exact procedure is re 'taking the button away' for pushing - it doesn't make pharmacological sense and is possibly just MW habit rather than policy - the anaesthetists would probably be the ones to clarify this with rather than MWs/obstetricians.

Yes OP- I was given the button to hold throughout labour- it was never taken off me.

TBH it would be a bit of a pointless method of pain relief if they let you get to the most painful part and then whipped it away!