Supervisor：Ministry of Education of the People's Republic of ChinaSponsor：Sichuan University Editor-in-chief：LUO Fengming Publishing period：
Monthly
ISSN：1002-0179CN：51-1356/R
Department of Anesthesiology, West China Second Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, P. R. China;
Objective
To explore the effect of epidural analgesia for labor on maternal temperature and the newborns.
Methods
This randomized trial was performed in West China Second Hospital between December 2015 and July 2016. Fifty puerperants were randomly divided into epidural analgesia (EA) group (natural labor under EA, n=25) or the control group (natural labor using Ramaze breathing method, n=25). Maternal tympanic temperature was recorded once per hour after treating with painless labor or blank control. The serum interleukin-1 beta (IL-1β) and heat shock protein 70 (HSP70) level were measured from the blood of the umbilical cord after the delivery. Apgar scores of the newborns were also recorded.
Results
There was a significant difference in the temperature between EA and control group one hour after the treatment of painless labor [ (36.9±0.7) and (36.4±0.5)℃]. The level of serum IL-1β and HSP70 were significantly higher in EA group [IL-1β: (0.308±0.036) ng/mL; HSP70: 1.175±0.196] than those in the control group [IL-1β: (0.244±0.031) ng/mL; HSP70: 0.935±0.308] (P<0.05). However, no significant difference was found in the neonatal Apgar score (P>0.05).
Conclusions
The increase of maternal temperature is greater in the EA labor puerperants compared with that in the controls, which may be related to the increase of IL-1β and HSP70. No adverse effect of labor analgesia on new borns is found
Citation：LIN Yuangui, LUO Linli. The effect of epidural analgesia for labor on maternal temperature. West China Medical Journal, 2017, 32(7): 1011-1014. doi: 10.7507/1002-0179.201701100Copy
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Tian FB, Wang K, Hu JY, et al. Continuous spinal anesthesia with sufentanil in labor analgesia can induce maternal febrile responses in puerperas. Int J Clin Exp Med, 2013, 6(5): 334-341.
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Sarikus Z, Bedirli N, Yilmaz G, et al. The effects of epidural bupivacaine on ischemia/reperfusion-induced liver injury. Bratisl Lek Listy, 2016, 117(1): 41-46.
Segal S. Labor epidural analgesia and maternal fever. Anesth Analg, 2010, 111(6): 1467-1475.
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Leighton BL, Halpern SH. The effects of epidural analgesia on labor, maternal, and neonatal outcomes: a systematic review. P Am J Obstet Gynecol, 2002, 186(5): 69-77.
15.
Greenwell EA, Wyshak G, Ringer SA, et al. Intrapartum temperature elevation, epiduraluse, and adverse outcome in term infants. Pediatrics, 2012, 129(2): 447-454.
2. Tian FB, Wang K, Hu JY, et al. Continuous spinal anesthesia with sufentanil in labor analgesia can induce maternal febrile responses in puerperas. Int J Clin Exp Med, 2013, 6(5): 334-341.
3. Van De Velde M, Dreelinck R, Dubios J, et al. Determination of the full dose-response relation of intrathecal bupivacaine, levobupivacaine, and ropivacaine combined with sufentanil, for labor analgesia . Anesthesiology, 2007, 106(3): 149-156.
4. Wong CA, Ratliff JT, Sullivan J, et al. A randomized comparison of programmed intermittent epidural bolus with continuous epidural infusion for labor analgesia. Anesth Analg, 2006, 102(1): 904-909.
7. Arendt KW, Segal BS. The association between epidural labor analgesia and maternal fever. Clin Perinatol, 2013, 40(3): 385-398.
8. Goetzl L, Evans T, Rivers J, et al. Elevated maternal and fetal serum interleukin-6 levels are associated with epidural fever. P Am J Obstet Gynecol, 2002, 187(4): 834-838.
9. Goetzl L, Zighelboim I, Badell M, et al. Maternal corticosteroids to prevent intrauterine exposure to hyperthermia and inflammation: a randomized, double-blind, placebo-controlled trial. P Am J Obstet Gynecol, 2006, 195(4): 1031-1037.
11. Sarikus Z, Bedirli N, Yilmaz G, et al. The effects of epidural bupivacaine on ischemia/reperfusion-induced liver injury. Bratisl Lek Listy, 2016, 117(1): 41-46.
13. Segal S. Labor epidural analgesia and maternal fever. Anesth Analg, 2010, 111(6): 1467-1475.
14. Leighton BL, Halpern SH. The effects of epidural analgesia on labor, maternal, and neonatal outcomes: a systematic review. P Am J Obstet Gynecol, 2002, 186(5): 69-77.
15. Greenwell EA, Wyshak G, Ringer SA, et al. Intrapartum temperature elevation, epiduraluse, and adverse outcome in term infants. Pediatrics, 2012, 129(2): 447-454.
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Citation：LIN Yuangui, LUO Linli. The effect of epidural analgesia for labor on maternal temperature. West China Medical Journal, 2017, 32(7): 1011-1014. doi: 10.7507/1002-0179.201701100
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