{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T18:51:18Z","timestamp":1788115878444,"version":"build-2803163510"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T00:00:00Z","timestamp":1671408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Remifentanil patient-controlled analgesia (rPCA) and epidural analgesia (EA) has been used for pain relief in labor. We aimed to evaluate the efficacy and safety of rPCA versus EA in labor, to provide evidence support for clinical analgesia and pain care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, EMBASE, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang and Weipu databases for RCTs comparing rPCA and EA in labor until February 15, 2022. Two researchers independently screened literature and extracted data. RevMan 5.3 software was used for data analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 10 RCTs involving 3086 parturients were enrolled, 1549 parturients received rPCA and 1537 received EA. Meta-analysis indicated that the incidence of intrapartum maternal fever within 1 hour of labor analgesia (OR = 0.43, 95%CI: 0.30~0.62), after 1 hour of labor analgesia (OR = 0.42, 95%CI: 0.20~0.90) in the rPCA was significantly less than that of EA (all P&lt;0.05). The incidence of respiratory depression (OR = 3.56, 95%CI: 2.45~5.16, P&lt;0.001) in the rPCA was significantly higher than that of EA. There were no significant differences in the incidence of Apgar scores&lt;7 at 5 minutes (OR = 1.18, 95%CI: 0.71~1.96, P = 0.53), the patients\u2019 satisfaction of pain relief during labor analgesia (SMD = 0.03, 95%CI: -0.40~0.46, P = 0.90) between rPCA and EA (all P&gt;0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>rPCA can be an optional alternative to EA with similar pain relief and less risk of intrapartum maternal fever. However, rPCA was associated with increased risk of respiratory depression. Future studies with rigorous design and larger sample size are needed to provide more reliable evidences for clinical rPCA and EA use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0275716","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T13:25:13Z","timestamp":1671456313000},"page":"e0275716","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":21,"title":["The efficacy and safety of remifentanil patient-controlled versus epidural analgesia in labor: A meta-analysis and systematic review"],"prefix":"10.1371","volume":"17","author":[{"given":"Xiuzhen","family":"Lei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuyuan","family":"Gan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongxing","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfeng","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0151-4674","authenticated-orcid":true,"given":"Xianhui","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"issue":"1","key":"pone.0275716.ref001","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/ACO.0000000000000949","article-title":"COVID 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Chenmeng","year":"2009","journal-title":"Shandong Medicine"},{"issue":"3","key":"pone.0275716.ref041","first-page":"8","article-title":"Concurrent controlled study on the efficacy of intravenous patient-controlled labor analgesia with remifentanil and sufentanil combined with ropivacaine epidural patient-controlled labor analgesia","volume":"12","author":"Y Yibing","year":"2016","journal-title":"Chinese Women\u2019s and Children\u2019s Clinical Medicine Magazine"},{"issue":"9","key":"pone.0275716.ref042","first-page":"4","article-title":"Comparison of patient-controlled intravenous analgesia with remifentanil and combined lumbar-epidural analgesia for labor analgesia","volume":"34","author":"Z Aibing","year":"2018","journal-title":"Journal of Clinical Anesthesiology"},{"issue":"4","key":"pone.0275716.ref043","first-page":"539","article-title":"Labor analgesia in preeclampsia: remifentanil patient controlled intravenous analgesia versus epidural analgesia","volume":"20","author":"H 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