Abstract
Background
Labor epidural analgesia is associated with maternal hyperthermia. This pilot study
compared the effects on maternal temperature during labor of different timing of initiation
of the epidural component of combined spinal–epidural analgesia.
Methods
After induction of analgesia with intrathecal bupivacaine 2 mg and fentanyl 20 μg, healthy term nulliparas in spontaneous labor were randomized to receive immediate
epidural analgesia (n = 26) or delayed epidural analgesia after the return of pain (n = 28), by patient-controlled epidural analgesia with 0.125% bupivacaine and fentanyl
1 μg/mL. Maternal tympanic temperature, visual analog scale pain score and dermatome
block level were measured hourly during labor.
Results
The duration of labor for most parturients (83.3%) was <5 h. Mean maternal temperature gradually increased over time but did not significantly
differ from either from baseline or between the two groups. There was no significant
difference in the incidence of maternal fever (⩾38°C) between the two groups. At 2 h post spinal analgesia the visual analog scale score was higher (P = 0.03) and the dermatome block level was lower (P = 0.005) in the delayed epidural analgesia group compared to the immediate epidural
analgesia group.
Conclusions
Delaying the epidural component of combined spinal–epidural analgesia did not significantly
affect maternal temperature in the study population of whom 83.3% had a labor of <5 h. However, this study was underpowered to detect a difference in the incidence of
fever and a larger prospective study is required.
Keywords
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Article info
Publication history
Published online: August 16, 2011
Accepted:
June 6,
2011
Identification
Copyright
© 2011 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
