{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:32:18Z","timestamp":1784043138038,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,4,18]],"date-time":"2017-04-18T00:00:00Z","timestamp":1492473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"SingHealth Foundation Clinical Research","award":["SHF\/FG558P\/2014"],"award-info":[{"award-number":["SHF\/FG558P\/2014"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Intravenous remifentanil patient\u2010controlled analgesia can be used during labour as an alternative to epidural analgesia. Adverse effects of opioids, including hypoxia and bradycardia, may lead to maternal morbidity and mortality. We devised an interactive feedback system based on a clinical proportional algorithm, to continuously monitor for adverse effects to enhance safety and better titrate analgesia. This vital signs\u2010controlled, patient\u2010assisted intravenous analgesia with remifentanil used a prototype delivery system linked to a pulse oximeter that evaluated maternal oxygen saturation and heart rate continuously. With this system, we detected oxygen saturation &lt; 95% for more than 60 s in 15 of 29 subjects (52%); and heart rate &lt; 60 min\n                    <jats:sup>\u22121<\/jats:sup>\n                    for more than 60 s in 7 of 29 subjects (24%) during use. The system automatically responded appropriately by reducing the dosages and temporarily halting remifentanil administration, thus averting further hypoxia and bradycardia.\n                  <\/jats:p>","DOI":"10.1111\/anae.13878","type":"journal-article","created":{"date-parts":[[2017,4,18]],"date-time":"2017-04-18T04:56:45Z","timestamp":1492491405000},"page":"845-852","source":"Crossref","is-referenced-by-count":18,"title":["A case series of vital signs\u2010controlled, patient\u2010assisted intravenous analgesia (\n                    <scp>VPIA<\/scp>\n                    ) using remifentanil for labour and delivery"],"prefix":"10.1111","volume":"72","author":[{"given":"W. L.","family":"Leong","sequence":"first","affiliation":[{"name":"Department of Women's Anaesthesia KK Women's and Children's Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. L.","family":"Sng","sequence":"additional","affiliation":[{"name":"Department of Women's Anaesthesia KK Women's and Children's Hospital Singapore"},{"name":"Duke\u2010NUS Medical School Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.","family":"Zhang","sequence":"additional","affiliation":[{"name":"SingHealth Anaesthesiology Residency Program Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. L. R.","family":"Han","sequence":"additional","affiliation":[{"name":"Division of Clinical Support Services KK Women's and Children's Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Sultana","sequence":"additional","affiliation":[{"name":"Centre for Quantitative Medicine Duke\u2010NUS Medical School Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. T. H.","family":"Sia","sequence":"additional","affiliation":[{"name":"Department of Women's Anaesthesia KK Women's and Children's Hospital Singapore"},{"name":"Duke\u2010NUS Medical School Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(84)90079-4"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199529020-00003"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199806000-00008"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181c03e0c"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3182289fe9"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0b013e32834fc260"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep359"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2011.06997.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2012.07273.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000260645.48266.f1"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-5-412"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12099"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2015.12.004"},{"key":"e_1_2_6_15_1","first-page":"951","article-title":"Computer\u2010integrated patient\u2010controlled epidural analgesia: a preliminary study on a novel approach of providing pain relief in labour","volume":"47","author":"Sia AT","year":"2006","journal-title":"Singapore Medical Journal"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2013.11.007"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200204000-00026"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/87.3.415"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03022956"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.8.18.3089"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12038"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2012.2232666"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/88.3.374"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aei219"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13781"}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fanae.13878","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.13878","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T16:17:17Z","timestamp":1761668237000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.13878"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,18]]},"references-count":24,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1111\/anae.13878"],"URL":"https:\/\/doi.org\/10.1111\/anae.13878","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"value":"0003-2409","type":"print"},{"value":"1365-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,18]]}}}