Ropivacaine at different concentrations on intrapartum fever, IL‑6 and TNF‑α in parturient with epidural labor analgesia

Abstract

Effects of ropivacaine at different concentrations on intrapartum fever, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in parturient with epidural labor analgesia were compared to provide reference for the rational selection of anesthetics in clinic. Medical records of 198 cases of primi-paras admitted to the Obstetrics and Gynecology Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, from January 2017 to January 2018 were analyzed retrospectively and divided into 2 groups. A total of 105 patients were treated with 0.075% ropivacaine injection 10 ml and 0.5 µg/ml sulfentanyl injection 100 ml in parturition as the experimental group, and 93 patients were treated with 0.1% ropivacaine injection 10 ml and 0.5 µg/ml sulfentanyl injection 100 ml in parturition as the control group. After patient-controlled epidural analgesia, the pain visual analogue score (VAS), labor duration, administration time and febrile rate of parturient after administration were compared between the two groups at different time-points. Venous blood 2 ml was taken at T1 (cervix open to 2 cm), T2 (cervix fully open) and T3 (24 h postpartum), and the concentration of IL-6 TNF-α was detected by enzyme-linked immunosorbent assay. The time of the second stage of labor and analgesia were shorter in the experimental group than that in the control group after administration (P<0.05). The febrile rate of parturient in the experimental group was lower than that in the control group (P<0.05). The concentration of IL-6 and TNF-α in the experimental group was lower than that in the control group at T2 (P<0.05; P<0.01). The effect of patient-controlled epidural administration with 0.075% ropivacaine injection combined with 0.5 mg/ml sulfentanyl injection on labor analgesia is shorter than that with 0.1% ropivacaine combined with sulfentanyl. It could also shorten the duration of the second stage of labor, reduce the intrapartum febrile rate, and alleviate inflammation.

Risk Factors and Safety Analyses for Intrapartum Fever in Pregnant Women Receiving Epidural Analgesia During Labor

“…We also speculate that it may be related to the low concentration of local anesthetics we use and the intermittent pulse infusion of the analgesia pump. This view has been supported in previous studies, many of which found that duration of epidural analgesia is associated with intrapartum fever in most cases in which high concentrations of local anesthetics were used, or in which the epidural analgesia pattern was continuous [ 17 – 19 ].…”

Time- and dose-dependent correlations between patient-controlled epidural analgesia and intrapartum maternal fever

“…Riley et al found that women with ERMF had higher levels of proinflammatory cytokines (IL-6 and IL-8) even before receiving epidural analgesia, and the subsequent prolonged use of epidural bupivacaine increased the baseline cytokine levels gradually [ 14 ]. Zhou et al found that the IL-6 and tumor necrosis factor (TNF)-α levels of their 0.075% ropivacaine group were significantly lower than those of their 0.1% ropivacaine group [ 15 ]. The use of 0.075% ropivacaine caused less inflammation.…”

Epidural Dexmedetomidine for Prevention of Intrapartum Fever During Labor Analgesia: A Randomized Controlled Trial

“…In addition, dexmedetomidine inhibited tumor necrosis factor-a and interleukin-6 expression to alleviate inflammation by suppression of c-Jun N-terminal kinases [19]. A recent document reported that lower concentrations of ropivacaine reduced the rate of intrapartum fever during labor analgesia [20].…”