THE USE OF REMIFENTANIL INFUSION TO FACILITATE EPIDURAL CATHETER PLACEMENT IN A PARTURIENT - A CASE-REPORT WITH PHARMACOKINETIC SIMULATIONS

We present a case in which remifentanil infusion was used to provide a nalgesia during epidural catheter placement in a parturient who was ex periencing gnat difficulty staying motionless because of extremely pai nful uterine contractions. Remifentanil may provide certain advantages in this setting, including improved analgesia during the procedure, b riefer residual maternal and fetal (or newborn) drug effects after the procedure, and greater technical ease of catheter placement because o f decreased movement induced by pain. Pharmacokinetic simulation of th e dose administered suggests that analgesic effect-site concentrations can be rapidly produced, and that these concentrations decline rapidl y to clinically insignificant levels after the infusion.