Intravenous Remifentanil Patient-controlled Analgesia (PCA) and Epidural Patient Controlled Epidural Analgesia (PCEA) for Labor Analgesia

Inclusion criteria:

• Healthy women
• American Society of Anesthesiologists physical status class I or II
• Body weight less than 110 kg
• In active labor (including induced labor and premature rupture of membranes)
• Cervical dilatation at 2-6 cm
• Regular contractions
• Age between 18 and 40 years old
• Gestational age greater than 36 completed weeks
• Singleton pregnancy and vertex presentation

Exclusion criteria:

• Contraindication for epidural analgesia (bleeding diathesis, neuropathy, severe scoliosis, previous spine surgery, local anesthetic allergy)
• Narcotic administration in the previous 2 hours
• Previous uterine surgery
• Pre-eclampsia and the inability to adequately understand the consent form
• Blocked nose, and any indication patient for whom epidural analgesia is medically indicated (cardiac disease, suspected difficult airway)