Selected Guideline Examples Date
University Hospital Southampton Sept 2018
Lancashire Teaching Hospitals
July 2018
Wider Scope

General Points
  • Remifentanil being used more widely 
  • Not to be given within 4 hours of other parenteral opiates
  • Not routinely used in preterm mothers (<36/40)
  • Patient information sheet good practise
  • One to one midwifery care with observation chart essential
We Liked
  • Description of Remifentanil and details of preparation for PCA
  • Reminder of the dangers of Remifentanil and unlicensed drug
  • Explicit mention of dedicated, labelled cannula and not to flush
  • Specifics of how to prevent desaturation and measures necessary if desaturation does occur
  • Clear layout of guidelines
  • Information sheet for mothers
  • Comparison with epidurals (Southampton)
  • Reminder to continue monitoring for half an hour after discontinue
  • Accurate and complete information 
  • Mentions intrauterine-death as a contraindication.
  • Information to the parturient about 1:1 midwife care
  • Comprehensive and clear
We Didn't Like

Not Sure

  • The more midwifery staff are using Remifentanil, the better in terms of their experience. If only using it once or twice per year may not be confident in use and aware of how to deal wih complications

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