Which opioid is best for the management of labor pain?
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Which opioid is best for the management of labor pain? Evidence-Based Answer: It is unclear which opioid is the most effective when given by patient-controlled analgesia (PCA): remifentanil may be more effective than fentanyl (SOR: B, single RCT) and nalbuphine may be more effective than meperidine (SOR: B, single RCT), yet remifentanil is equally effective as meperidine (SOR: A, meta-analysis). Given as needed intravenously (IV), butorphanol is more effective than either IV fentanyl or IV meperidine (SOR: B, single RCTs).
Evidence Based Practice 18(2): E1-E2