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Maternal temperature regulation during extradural analgesia for labour
W R Camann1, L A Hortvet, N Hughes
1Department of Anaesthesia, Brigham and Women's Hospital, Boston, Massachusetts 02115.
British Journal of Anaesthesia
|November 1, 1991
Summary
Epidural analgesia during labor significantly increases maternal body temperature. This effect was observed in women receiving epidural anesthesia but not in those receiving opioid pain relief, suggesting altered heat dissipation mechanisms.
Area of Science:
- Obstetrics and Gynecology
- Anesthesiology
- Maternal Health
Background:
- Maternal temperature regulation during labor is crucial.
- Pain management options during labor include epidural and parenteral analgesia.
- The impact of different analgesia types on maternal thermoregulation is not fully understood.
Purpose of the Study:
- To investigate the effect of epidural analgesia versus parenteral opioid analgesia on maternal temperature progression during normal spontaneous labor.
- To identify potential changes in thermoregulation associated with different pain management strategies.
Main Methods:
- A study involving 53 women in normal spontaneous labor.
- Three groups: continuous extradural analgesia (bupivacaine with or without fentanyl) and parenteral opioid analgesia.
- Maternal temperature monitored orally and via tympanic membrane.
Main Results:
- Women receiving extradural analgesia showed a significant increase in body temperature after approximately 5 hours.
- No significant temperature trend was observed in the group receiving parenteral opioid analgesia.
- All patients were afebrile and showed no signs of infection at baseline.
Conclusions:
- Epidural analgesia, particularly with bupivacaine and fentanyl, is associated with a rise in maternal temperature during labor.
- Parenteral opioid analgesia does not appear to affect maternal temperature progression.
- Altered heat dissipation mechanisms may explain the observed temperature increase with epidural analgesia.