title: Influence of epidural dexamethasone on maternal temperature and serum cytokine concentration after labor epidural analgesia.
abstract: OBJECTIVE
  To evaluate the effects of epidural dexamethasone on maternal temperature and serum cytokine levels after labor epidural analgesia.
  
  
  METHODS
  Sixty healthy term nulliparas in spontaneous labor were randomized to receive epidural analgesia alone using bupivacaine 0.125% and fentanyl 1 μg/mL (group I) or epidural analgesia combined with dexamethasone 0.2mg/mL (group II) (n=30 per group). Maternal tympanic temperature was measured before epidural analgesia and hourly thereafter until delivery. Maternal and cord venous blood were sampled for analysis of interleukin-6 (IL-6), tumor necrosis factor-α, and interleukin-10 levels.
  
  
  RESULTS
  There was no difference in the incidence of intrapartum fever (38 °C or more) between the 2 groups (3/30 versus 1/30, P=0.612). The mean maternal temperature increased with time in group I, with the elevation reaching statistical significance at 4 hours post analgesia and at delivery compared with baseline (P=0.012 and P=0.043, respectively). A similar trend was observed with maternal serum IL-6 levels in group I. In group II, maternal temperature and IL-6 levels did not differ from baseline at any time point during labor.
  
  
  CONCLUSIONS
  Epidural dexamethasone alleviates maternal temperature elevation after epidural analgesia. This effect can be attributed to the decrease in IL-6 levels.
authors.affiliation: Department of Anesthesiology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China. jxlzw@sina.com
authors.forename: Li-Zhong
authors.initials: LZ
authors.lastname: Wang
authors.forename: Xiao-Xia
authors.initials: XX
authors.lastname: Hu
authors.forename: Xia
authors.initials: X
authors.lastname: Liu
authors.forename: Ping
authors.initials: P
authors.lastname: Qian
authors.forename: Jia-Mei
authors.initials: JM
authors.lastname: Ge
authors.forename: Bei-Lei
authors.initials: BL
authors.lastname: Tang
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000009:adverse effects / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000494:pharmacology*; D001831:Body Temperature / Q000187:drug effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use; D016207:Cytokines / Q000097:blood / Q000187:drug effects; D003907:Dexamethasone / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy; D013997:Time Factors; D055815:Young Adult
chemical_list: D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D016207:Cytokines; D003907:Dexamethasone; D005283:Fentanyl; D002045:Bupivacaine