Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Clin Perinatol. 2013 Sep;40(3):385-98. doi: 10.1016/j.clp.2013.06.002. Epub 2013 Jul 19.
The association between epidural labor analgesia and maternal fever is complex and controversial. Observational, retrospective, before-and-after, and randomized controlled trials all support the association, with the most current evidence supporting the mechanistic involvement of noninfectious inflammation. Considering the clinically significant neonatal consequences that have been previously demonstrated, and the possibility of more common subclinical fetal brain injury that animal models imply, the avoidance of maternal fever during labor is imperative. With the current popularity of epidural analgesia in labor, it is important that clinicians delineate how epidurals cause maternal fever and how to block the noninfectious inflammatory response that seems to warm a subset of women laboring with epidurals.
硬膜外分娩镇痛与产妇发热之间的关系是复杂且有争议的。观察性、回顾性、前后对照和随机对照试验均支持这种关联，最新证据支持非感染性炎症的作用机制。鉴于之前已经证实了与临床相关的新生儿后果，以及动物模型提示的更常见的亚临床胎儿脑损伤的可能性，在分娩过程中避免产妇发热是至关重要的。由于目前硬膜外镇痛在分娩中的广泛应用，临床医生明确硬膜外如何引起产妇发热以及如何阻断似乎使一部分使用硬膜外分娩的女性发热的非感染性炎症反应是很重要的。
