Opioids are routinely avoided during induction to general
anaesthesia for caesarean section because of the potential
for respiratory depression in the neonate [1,2].
On the other hand, insufficient depth of analgesia in
parturients until foetal delivery remains a concern for obstetric anaesthetists [3,4]. Therefore, the ultra shortacting
μ1-receptor agonist remifentanil has been
suggested as a replacement for longer acting opioids in
parturients undergoing caesarean delivery [5-11]. Remifentanil
rapidly crosses the placenta but simultaneously
is quickly eliminated from the neonatal circulation by
degradation with nonspecific esterases in plasma and/or
redistribution [12-14]. With a half-life of 3–10 minutes,
remifentanil should be almost entirely eliminated from
foetal circulation by the time of delivery [15]. However,
in obstetrics, despite promising pharmacokinetics
and pharmacodynamics, remifentanil is currently