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Effects of regular intermittent bolus and continuous infusion on maternal fever during epidural labor analgesia
Abstract Number: T-24
Abstract Type: Original Research
Background. Epidural labor analgesia is associated with maternal fever. On- demand intermittent epidural injections showed a lower incidence of intrapartum fever than continuous infusion during early labor analgesia. The aim of this study was to determine the accidence of maternal fever of regular intermittent epidural bolus and continuous infusion during labor analgesia.
Methods. After establishing epidural analgesia with 10 ml of 0.125% ropivacaine + 0.4 μg•ml-1 sufentanil, all parturients received either regular intermittent bolus (RIB, n= 66) or continuous infusion (CI, n= 66) epidural labor analgesia. In the RIB group, bolus dose of 10 ml of 0.08% ropivacaine + 0.4 μg•ml-1 sufentanil was manually given hourly beginning 75 min post analgesia; In the CI group, the same solution was continuously infused at a constant rate of 10 ml•h -1 beginning 15 min post analgesia. All patients had breakthrough pain were administrated initially with 5 ml of 0.08% ropivacaine + 0.4 μg•ml-1 sufentanil followed by 5 ml of 0.15% ropivacaine. Maternal tympanic temperature was measured and peripheral venous blood was drawn before epidural analgesia and hourly thereafter until 1 h post partum. Cord blood was drawn post delivery and baby’s temperature was recorded at 30 min post delivery. The incidences of fever (≥ 38 degrees Celsius) were calculated and blood samples interleukin- 6 (IL- 6) levels were measured. The effects on labor outcome in both groups were also compared.
Results. One hundred and twenty- five subjects completed the study protocol and were finally included in the analyses. The hourly (Table 1), total incidence of maternal fever (6/63 in RIB vs. 8/62 in CI, P= 0.549), and baby’s temperature were similar between the two groups. Mean maternal temperatures gradually rose over time in both groups but the differences did not reach statistical significance at any time points between two groups, maternal serum IL- 6 presented similar changes.
Conclusion. Regular intermittent bolus demonstrates similar incidence of maternal fever compared to continuous infusion for epidural labor analgesia. IL-6 elevation could be involved in the increase in mean maternal temperature.
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