Feng Shan-Wu, Xu Shi-Qin, Ma Li, Li Cai-Juan, Wang Xian, Yuan Hong-Mei, Wang Fu-Zhou, Shen Xiao-Feng, Ding Zheng-Nian
Department of Anesthesiology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China. E-mail.
Saudi Med J. 2014 Oct;35(10):1237-42.
To compare the effects of regular intermittent bolus versus continuous infusion for epidural labor analgesia on maternal temperature and serum interleukin-6 (IL-6) level.
This randomized trial was performed in Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu Province, China between October 2012 and February 2014. Either regular intermittent bolus (RIB, n=66) or continuous infusion (CI, n=66) was used for epidural labor analgesia. A bolus dose (10 ml of 0.08% ropivacaine + 0.4 ug·ml-1 sufentanil) was manually administrated once an hour in the RIB group, whereas the same solution was continuously infused at a constant rate of 10 ml·h-1 in the CI group. Maternal tympanic temperature and serum IL-6 level were measured hourly from baseline to one hour post partum. The incidences of fever (>/=38 degree celsius ) were calculated.
The incidence of maternal fever was similar between the 2 groups. There was a rising trend in mean temperature over time in both groups, but no statistical difference was detected between the groups at respective time points; maternal serum IL-6 showed similar changes.
Compared with continuous infusion, regular intermittent bolus presents with the same incidence of maternal fever for epidural labor analgesia. Interleukin-6 elevation could be involved in mean maternal temperature increase.
比较硬膜外分娩镇痛时常规间歇性推注与持续输注对产妇体温及血清白细胞介素-6(IL-6)水平的影响。
本随机试验于2012年10月至2014年2月在中国江苏省南京市妇幼保健院进行。硬膜外分娩镇痛采用常规间歇性推注(RIB,n=66)或持续输注(CI,n=66)。RIB组每小时手动推注一次剂量(10 ml 0.08%罗哌卡因+0.4 μg·ml-1舒芬太尼),而CI组以10 ml·h-1的恒定速率持续输注相同溶液。从基线到产后1小时每小时测量产妇鼓膜温度和血清IL-6水平。计算发热(≥38摄氏度)的发生率。
两组产妇发热发生率相似。两组平均体温均随时间呈上升趋势,但各时间点两组间未检测到统计学差异;产妇血清IL-6呈现相似变化。
与持续输注相比,常规间歇性推注用于硬膜外分娩镇痛时产妇发热发生率相同。白细胞介素-6升高可能与产妇平均体温升高有关。