[Important metabolic parameters in the peripartum period as affected by peridural anesthesia]

In a clinical study we compared two groups of healthy patients at term: - 10 patients received no analgesics or very small doses of pethidine (control group) during the course of labour, - 17 patients were given CO2-bupivacaine via epidural catheter because they asked for it and because their obstetricians prescribed it (CEDA-group). After giving the same infusion solution of 120 ml/h 5% half-isotonic fructose to all the parturients, the following biochemical parameters were measured at the beginning and at the end of the first stage of labour, at delivery, and two hours later: Blood gases and acid-base status, blood sugar, lactate, betahydroxybutyric acid, ACTH, cortisol, hematocrit, electrolytes, and serum osmolality. The above mentioned parameters, except electrolytes and serum osmolality, were also determined in umbilical-cord blood immediately after delivery. In the labour ward, infants were observed and their capillary blood gases, acid-bases status, and blood sugar were measured 30, 60, and 120 minutes after birth. Lactate, betahydroxybutyric acid, ACTH, and cortisol levels rose significantly until delivery in both of the groups; significant differences between the two groups could be seen in blood gases, blood sugar, and ACTH levels. In the umbilical cord there were only significant differences in blood sugar. In summary it can be concluded that although labour pain can be controlled by epidural analgesia, the stress of labour is only influenced by different analgesic methods to a certain degree.