Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2017 Mar;96(11):e6256.
doi: 10.1097/MD.0000000000006256.

Remifentanil analgesia during external cephalic version for breech presentation in nulliparous women at term: A randomized controlled trial

Zhi-Hong Wang  1 , Yi Yang, Gui-Ping Xu
Affiliations
Randomized Controlled Trial

Remifentanil analgesia during external cephalic version for breech presentation in nulliparous women at term: A randomized controlled trial

Zhi-Hong Wang et al. Medicine (Baltimore). 2017 Mar.

Abstract

Background: The aim of the study was to assess the efficacy and safety of remifentanil for pain relief during external cephalic version (ECV) for breech presentation in nulliparous women at term.

Methods: A total of 144 nulliparous women with singleton breech presentation were randomly divided into the intervention group and the placebo group, with 72 subjects in each group. The subjects in the intervention group received remifentanil (infused at 0.1 μg kg min with demand boluses of 0.1 μg/kg), whereas those in the placebo group were given saline placebo. This study was conducted from May 2013 to April 2016. The outcomes measures include pain (measured with the visual analog scale, VAS), success rate of ECV, maternal satisfaction for ECV, and adverse events.

Results: A total of 137 participants completed the study. The intervention with remifentanil showed greater efficacy than did placebo in decreasing the VAS score immediately after ECV (intervention group 4.3 ± 2.2 vs placebo group 6.4 ± 2.5, P < 0.01). A significant difference in the ECV success rate was also found between the 2 groups (intervention group 56.9% vs placebo group 38.9%, P = 0.03). In addition, a significant difference in the satisfaction score was also detected (intervention group 9.3 ± 0.9 vs placebo group 6.7 ± 1.2, P < 0.01). The observed adverse events were similar between the 2 groups.

Conclusion: This study shows that remifentanil could decrease pain, improve the ECV success rate, and improve satisfaction in nulliparous women at term during the period of ECV. Furthermore, it is also well tolerated with few adverse events.

PubMed Disclaimer

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow of participants through the trial.
See this image and copyright information in PMC

References

    1. Kok M, Cnossen J, Gravendeel L, et al. Ultrasound factors to predict the outcome of external cephalic version: a meta-analysis. Ultrasound Obstet Gynecol 2009;33:76–84. - PubMed
    1. American College of Obstetricians and Gynecologysts. External cephalic version. ACOG Practice Bulletin No. 13, February 2000.
    1. Collaris RJ, Oei SG. External cephalic version: a safe procedure? A systematic review of version-related risks. Acta Obstet Gynecol Scand 2004;83:511–8. - PubMed
    1. Zhao E, Wei Y, Zhang Y, et al. A comparison of transthroracic echocardiograpy and transcranial Doppler with contrast agent for detection of patent foramen ovale with or without the valsalva maneuver. Medicine (Baltimore) 2015;94:e1937. - PMC - PubMed
    1. Burgos J, Melchor JC, Cobos P, et al. Ana’lisis del dolor en la versio’n externa. Prog Obstet Ginecol 2009;52:557–61.

Publication types