111 – Remifentanil PCA in labour – the Belfast experience with Mike Jamison

Obsgynaecritcare

Hi Everyone, In our tertiary women's hospital here in Perth we use remifentanil PCA in labour approximately 15 times a year - and we are told that in Australian terms this is considered a "heavy user" of this labour analgesic technqiue. This week I sit down with Mike Jamison an anaesthetic fellow from Belfast spending a year with us here in Perth. When he arrived in WA we quickly learned from him that remifentanil PCA is commonly used for labour analgesia in Northern Ireland with one unit he worked in having prescribed this technique for more than 11,000 women. We sit down to have a deep dive into the use of remifentanil PCA in labour in Northern Ireland. What aspects of their approach have led it to become such a commonly utilised technique? What is their recipe? How do they prescribe it, how do they monitor the women and how is this technique now viewed amongst the obstetric, midwifery and wider Northern Irish community! If you are attending the upcoming Obstetric Anaesthesia satellite meeting in Sydney in a few weeks - come along to hear Mike talk on this in person! References Intravenous remifentanil patient-controlled analgesia versus intramuscular pethidine for pain relief in labour (RESPITE): an open-label, multicentre, randomised controlled trial. The Lancet volume 392, p662-672, AUGUST 25, 2018 Remifentanil patient-controlled intravenous analgesia during labour: a retrospective observational study of 10 years' experience. H Murray, P Hodgkinson, D Hughes. Int J Obstet Anesth 2019 Aug;39:29-39