“Do no harm” - Where to place remifentanil for labour analgesia?

- Remifentanil PCA is arguably the second most effective analgesic method in labour after neuro-axial analgesia.
- Remifentanil PCA has not had long-term sequelae described so far. It is not hazardous to the environment or medical staff.
- The unique metabolism of remifentanil into inactive products without accumulation presents a benefit over other opioids.
- It is associated with the risk of respiratory suppression in the mother and neonate which implies strict safety standards.