Sultan Pervez, David Anna L, Fernando Roshan, Ackland Gareth L
From the *Department of Anaesthesia, University College London Hospital, London, United Kingdom; †Department of Obstetrics and Maternal Fetal Medicine, University College London Hospital, London, United Kingdom; and ‡William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
Anesth Analg. 2016 May;122(5):1546-53. doi: 10.1213/ANE.0000000000001195.
Intrapartum fever is associated with excessive maternal interventions as well as higher neonatal morbidity. Epidural-related maternal fever (ERMF) contributes to the development of intrapartum fever. The mechanism(s) for ERMF has remained elusive. Here, we consider how inflammatory mechanisms may be modulated by local anesthetic agents and their relevance to ERMF. We also critically reappraise the clinical data with regard to emerging concepts that explain how anesthetic drug-induced metabolic dysfunction, with or without activation of the inflammasome, might trigger the release of nonpathogenic, inflammatory molecules (danger-associated molecular patterns) likely to underlie ERMF.
产时发热与过多的产妇干预以及较高的新生儿发病率相关。硬膜外相关产妇发热(ERMF)促使产时发热的发生。ERMF的机制仍不清楚。在此,我们探讨局部麻醉药如何调节炎症机制及其与ERMF的相关性。我们还严格重新评估了关于新出现概念的临床数据,这些概念解释了麻醉药物诱导的代谢功能障碍,无论有无炎性小体激活,如何可能触发可能是ERMF基础的非致病性炎症分子(危险相关分子模式)的释放。