Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil.
Br J Anaesth. 2011 Nov;107(5):762-8. doi: 10.1093/bja/aer218. Epub 2011 Jul 9.
We determined the association between combined spinal-epidural (CSE) anaesthesia and an increase in maternal intrapartum temperature and intrapartum fever.
A randomized, open clinical trial was performed with 70 pregnant women, 35 receiving CSE and 35 receiving only non-pharmacological methods of pain relief during delivery. Association between CSE and changes in the patient's temperature, the risk of maternal fever, and other maternal and perinatal outcomes was determined at a 5% significance level. Number needed to harm (NNH) was calculated for maternal fever.
Patients receiving CSE anaesthesia during vaginal delivery experienced a significant increase in intrapartum temperature and five (14%) developed fever, whereas no cases occurred in the group receiving only non-pharmacological methods of pain relief (P=0.027). None of the women who developed fever received antibiotics or were submitted to further investigation; however, all progressed without complication. No case of chorioamnionitis or any maternal or neonatal infection was detected. NNH for maternal fever was 7.0 (95% confidence interval: 3.8-51.9).
The use of CSE is associated with a significant increase in maternal temperature and in the incidence of intrapartum maternal fever. However, the increase in maternal temperature does not appear to provoke any deleterious effects on the mother or child.
我们确定了脊麻-硬膜外联合麻醉（CSE）与产妇产时体温升高和产时发热之间的关系。
进行了一项随机、开放的临床试验，共纳入 70 名孕妇，其中 35 名接受 CSE 麻醉，35 名仅在分娩时接受非药物止痛方法。在 5%的显著性水平下，确定 CSE 与患者体温变化、产妇发热风险以及其他产妇和围产儿结局之间的关系。计算了产妇发热的需要治疗人数（NNH）。
接受 CSE 麻醉的阴道分娩患者产时体温显著升高，有 5 名（14%）产妇发热，而仅接受非药物止痛方法的组无一例发热（P=0.027）。发热的产妇均未接受抗生素治疗或进一步检查，但均无并发症进展。未发现绒毛膜羊膜炎或任何产妇或新生儿感染。产妇发热的 NNH 为 7.0（95%置信区间：3.8-51.9）。
CSE 的使用与产妇体温升高和产时发热发生率增加显著相关。然而，产妇体温升高似乎不会对母亲或婴儿产生任何不良影响。
