First OAA Guidance Standardizes Remifentanil PCA for Labour Analgesia
This inaugural Obstetric Anaesthetists' Association guideline gives pharmacists concrete dosing, dilution line-safety, and monitoring parameters for remifentanil PCA in labour where neuraxial analgesia is contraindicated or declined.
📅 Journal publication: Jun 1, 2026(online May 6, 2026)·Last updated: Oct 7, 2026
New guidelines aim to standardise remifentanil PCA for labour analgesia.
Standardised guidelines for remifentanil patient-controlled analgesia (PCA) can improve safety and efficacy in labour when neuraxial techniques are contraindicated. Nineteen recommendations and six statements were developed with low to moderate certainty, addressing safety, patient suitability, and practical use. While highlighting standardisation, the guideline notes a lack of data for high-risk groups, indicating areas for further research. Clear protocols and staff training are essential for safe use of remifentanil PCA in labour.
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Authors:Hughes DA, Broom MA, Eley VA, Melber A, Metodiev Y, Maclennan K, Sundaram S, Van de Velde M, Anderson P, Lucas N
Citation:Hughes DA, Broom MA, Eley VA, et al. Remifentanil patient-controlled analgesia for labour analgesia: guidance from the obstetric anaesthetists' association: Recommendations for well tolerated provision of remifentanil PCA for labour analgesia. European journal of anaesthesiology. 2026;43(6):486-498. doi:10.1097/EJA.0000000000002373
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