Logtenberg Sabine L M, Vink M L, Godfried Marc, Beenakkers Ingrid C M, Freeman Liv M, Schellevis François G, Mol Ben Willem, Verhoeven Corine J
Academisch Medisch Centrum, afd. Obstetrie en Gynaecologie, Amsterdam en Academie Verloskunde Amsterdam Groningen.
Contact: S.L.M. Logtenberg (
Ned Tijdschr Geneeskd. 2018 May 1;162:D2816.
To survey (a) the frequency of the use of patient-controlled analgesic remifentanil-PCA during labour in the Netherlands; (b) considerations by obstetricians whether or not to offer remifentanil-PCA; (c) target population for remifentanil-PCA and (d) the application of maternal monitoring.
Descriptive survey.
A questionnaire was sent to all 81 Dutch hospitals with a labour ward. The following subjects were covered: (a) available methods for pharmacological pain relief; (b) considerations by obstetricians whether or not to offer remifentanil-PCA; (c) target population for remifentanil-PCA; (d) maternal monitoring and (e) the hospital's birth data for the year 2016. The hospital pharmacist was asked for the number of remifentanil dispensed in 2016-2017.
The questionnaire was completed by 81 obstetricians (100% response rate). Remifentanil-PCA was available in 59 out of 81 (73%) of the hospitals with a mean use of 23% of the births (range 16-56%) in those units. In 34 (58%) of these hospitals, remifentanil-PCA is available for all women, and in 25 (42%) it was for a selected group of women. Most frequently mentioned considerations for offering remifentanil-PCA were 'a need for an alternative for epidural analgesia' and 'at the request of pregnant women' reported a respective 55 (93%) and 46 (78%) times. In hospitals where remifentanil-PCA was not offered, the following motives were given for this policy: 'epidural analgesia is the most effective method of pain relief during labour'; 'risk of serious maternal complications'; and 'sufficient monitoring during labour not feasible in delivery rooms'.
A large variation between Dutch hospitals exists in the application of remifentanil-PCA during labour. In the majority of the hospitals, remifentanil-PCA is available for all women. The most common motives mentioned by obstetricians for its use are 'a need for an alternative for epidural analgesia' and 'at the request of pregnant women'.
调查（a）荷兰分娩期间使用患者自控镇痛瑞芬太尼-PCA的频率；（b）产科医生对于是否提供瑞芬太尼-PCA的考量；（c）瑞芬太尼-PCA的目标人群；以及（d）产妇监测的应用情况。
描述性调查。
向荷兰所有81家设有产科病房的医院发送了一份问卷。涵盖以下主题：（a）可用的药物镇痛方法；（b）产科医生对于是否提供瑞芬太尼-PCA的考量；（c）瑞芬太尼-PCA的目标人群；（d）产妇监测；以及（e）各医院2016年的分娩数据。向医院药剂师询问了2016 - 2017年瑞芬太尼的配药量。
81位产科医生完成了问卷（回复率100%）。81家医院中有59家（73%）提供瑞芬太尼-PCA，在这些医院中，其平均使用率为分娩总数的23%（范围为16% - 56%）。在其中34家（58%）医院，瑞芬太尼-PCA对所有女性可用，25家（42%）医院则针对特定女性群体。对于提供瑞芬太尼-PCA，最常提及的考量因素分别是“需要硬膜外镇痛的替代方法”（55次，占93%）和“应孕妇要求”（46次，占78%）。在未提供瑞芬太尼-PCA的医院，给出的该政策动机如下：“硬膜外镇痛是分娩期间最有效的镇痛方法”；“产妇出现严重并发症的风险”；以及“产房内分娩期间进行充分监测不可行”。
荷兰各医院在分娩期间使用瑞芬太尼-PCA的情况存在很大差异。在大多数医院，瑞芬太尼-PCA对所有女性可用。产科医生提及的使用该方法最常见的动机是“需要硬膜外镇痛的替代方法”和“应孕妇要求”。
