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An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
Intrapartum epidural analgesia and maternal temperature regulation
Laura Goetzl1, Jose Rivers, Israel Zighelboim
1Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina 29425, USA. goetzl@musc.edu
Objective:
To examine maternal temperature changes after epidural analgesia.
Methods:
A prospective cohort of nulliparas at term was monitored with hourly maternal tympanic temperatures after epidural analgesia (n=99). Temperature response after epidural analgesia was examined in the group as a whole. Subsequently, mean maternal temperature curves were compared between women who remained afebrile throughout labor (n=77) and women who developed intrapartum fever with body temperature greater than 100.4 degrees F (n=22). Baseline maternal characteristics were assessed.
Results:
Women who later developed intrapartum fever had a higher mean temperature within 1 hour after epidural analgesia. In contrast, women who remained afebrile had no increase in core temperature. During the first 4 hours after epidural analgesia initiation, women who later develop intrapartum fever have an increase in mean tympanic temperature of 0.33 degrees F per hour.
Conclusion:
Epidural analgesia is not associated with increased temperature in the majority of women. Hyperthermia is an abnormal response confined to a minority subset, which occurs immediately after exposure. Our findings do not support a universal perturbation of maternal thermoregulation after epidural analgesia.
Level Of Evidence:
II.
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