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Increased Pain Relief With Remifentanil Does Not Improve the Success Rate of External Cephalic Version: A Randomized Controlled Trial

Burgos, Jorge; Pijoan, José I.; Osuna, Carmen; Cobos, Patricia; Rodriguez, Leire; Del Mar Centeno, María; Serna, Rosa; Jimenez, Antonia; Garcia, Eugenia; Fernandez-Llebrez, Luis; Melchor, Juan C.

doi: 10.1097/01.aoa.0000512033.19979.c0
Anesthesia and Analgesia: Alternative Methods of Analgesia

(Acta Obstet Gynecol Scand. 2016;95:547–554)

One of the high-risk obstetric conditions is breech presentation, and this condition is usually associated with higher cesarean rates. External cephalic version (ECV) is used to decrease the number of breech presentations at delivery with effective results. However, ECV is a painful maneuver and this pain is said to promote reactive maternal abdominal muscle contraction and involuntary abdominal tensing, reducing the likelihood of successful version and causing some women to reject the technique. The objective of this study was to compare the effect of 2 pain relief methods (remifentanil vs. nitrous oxide) on the success rate of ECV.

Obstetrics and Gynecology Service, BioCruces Health Research Institute, Cruces University Hospital (UPV/EHU), Barakaldo, Spain

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