Which systemic opioid is best for the management of labor pain?
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Fentanyl may provide better pain relief, but is associated with more sedation than intravenous (IV) meperidine. (SOR: A, based on a systematic review.) Remifentanil administered IV as patient-controlled analgesia (PCA) is associated with lower pain scores and fewer conversions to epidural anesthesia than IV meperidine. (SOR: C, based a small RCT and a small observational study.)
Evidence Based Practice 14(1): 09.