Awareness about Remifentanil PCA – Survey of Midwives in a tertiary maternity unit in the UK
S Sebastian, G Bose, P Singh, Department of Anaesthesia, Royal Stoke University Hospital, Stoke-on-Trent, UK
Introduction : Royal Stoke University Hospital has a tertiary care maternity unit with annual birth rate of 6500. Remifentanil PCA for labour analgesia is used in our centre primarily when epidural is contraindicated or not feasible1. Respiratory and cardiac arrests have been reported with the use of Remifentanil PCA2,3.
This survey was undertaken to determine the understanding of our midwifery staff about the regimen and its side effect profile.
Methods : Anonymous questionnaire with 7 questions was handed over to midwifery staff over the course of a single day and the midwives from all the three shifts were requested to fill in and the data was analysed.
Results : A total of 32 responses were obtained.
Discussion : Many UK maternity units use Remifentanil for labour analgesia but much less frequently than epidural. Although 62% of midwives in our unit have used it, our data shows that only a few of them have been trained on its administration. It appears that about a third of midwives are not fully aware of the side effect profile or monitoring requirement as instructed by the department protocol. Our data shows requirement for training the midwives on the use of Remifentanil although the administration of the medicine is directly under the supervision of anaesthetists in our unit.