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Maternal temperature associated with continuous spinal labor analgesia
Abstract Number: T-40
Abstract Type: Original Research
Introduction: Several reports in recent years have described an increase in maternal temperature in association with labor epidural analgesia (LEA).  The relationship between maternal temperature and continuous spinal labor analgesia (CSLA) has never been reported.
Methods: In a retrospective cohort study, quality assurance data from December 2008 to December 2013 was reviewed, to identify patients who had CSLA. Each patient was matched with 2 patients who received LEA, based on parity, duration of labor (2-4 hours or >4 hours) and BMI. Maternal temperatures on admission and throughout labor were recorded. The standard protocol at our institution was to obtain maternal temperature every 2 hours in labor, but missing values were common.
Results: 33 patients had CSLA > 2 hours. No difference in maximal temperature or incidence of fever (T >38°C) was seen between CSLA and LEA groups. 5 patients in the LEA cohort (n=66) developed fever vs. 3 in the CSLA cohort (n=33), (p = 1). A clinical diagnosis of chorioamnionitis was made in 3 of 5 and 2 of 3 cases of fever in the LEA and CSLA groups, respectively. All cases with fever not attributed to chorioamnionitis, developed elevated temperature after >7 hours of catheterization.
Conclusion: The incidence of fever in both the spinal and epidural catheter cohorts (3%) is lower than in many other reports.  CSLA was associated with intrapartum temperature patterns similar to LEA. The stimulation of the epidural space may be more important than the type of neuraxial blockade. CSE labor analgesia has been reported to have similar rates of maternal fever to epidural analgesia. [2,3] Type of local anesthetic may affect fever rates.
1) Anesth Analg. 2010;111:1467-75.
2) Br J Anaesth. 2011;107(5):762-8.
3) Int J Obstet Anesth. 2011;20(4):312-7.
4) Chang Gung Med J. 2011;34(3):286-92.