Prophylactic acetaminophen does not prevent epidural fever in nulliparous women: A double-blind placebo-controlled trial

被引：36

作者：

Goetzl L. ^{[1
]}

Rivers J. ^{[2
]}

Evans T. ^{[1
]}

Citron D.R. ^{[3
]}

Richardson B.E. ^{[4
]}

Lieberman E. ^{[5
]}

Suresh M.S. ^{[2
]}

机构：

[1] Department of Obstetrics/Gynecology, Baylor College of Medicine, Houston, TX 77030

[2] Department of Anesthesiology, Baylor College of Medicine, Houston, TX 77030

[3] Department of Pathology, Baylor College of Medicine, Houston, TX 77030

[4] Department of Urology, Baylor College of Medicine, Houston, TX 77030

[5] Department of Obstetrics/Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA

来源：

Journal of Perinatology | 2004年 / 24卷 / 8期

关键词：

D O I：

10.1038/sj.jp.7211128

中图分类号：

学科分类号：

摘要：

Objective: Epidural analgesia is associated with a four- to five- fold increase in noninfectious maternal fever in nulliparous women. Fever prophylaxis may safely reduce both unnecessary neonatal sepsis evaluations and the potential effect of fever on the fetus. Study Design: We performed a randomized double-blind placebo-controlled study. Immediately after epidural placement, full-term nulliparas with a temperature of <99.5°F received acetaminophen 650 mg or placebo, per rectum, every 4 hours. Tympanic membrane temperatures were measured hourly. Our power to detect an effect of acetaminophen treatment on maternal temperature over time was 90%. Results: In all, 21 subjects were randomized to each arm. Treatment with acetaminophen did not impact maternal temperature curves. Fever > 100.4°F was identical in the acetaminophen and placebo groups (23.8%, p = 1.0). Neonatal surveillance blood cultures did not reveal occult infection. Conclusions: Acetaminophen prophylaxis prevented neither maternal hyperthermia nor fever secondary to epidural analgesia, suggesting that the mechanism underlying fever does not include centrally mediated perturbations of maternal thermoregulation. © 2004 Nature Publishing Group. All rights reserved.

引用

页码：471 / 475

页数：4

共 18 条

[1]

Sharma S.K., Alexander J.M., Messick G., Et al., A randomized trial of epidural analgesia versus intravenous meperidine analgesia during labor in nulliparous women, Anesthesiology, 96, pp. 546-551, (2002)

[2]

Philip J., Alexander J.M., Sharma S.K., Et al., Epidural analgesia during labor and maternal fever, Anesthesiology, 90, pp. 1271-1275, (1999)

[3]

Hynson J.M., Sessler D.I., Glosten B., McGuire J., Thermal balance and tremor patterns during epidural anesthesia, Anesthesiology, 74, pp. 680-690, (1991)

[4]

Eltzschig H.K., Lieberman E.S., Camann W.R., Regional anesthesia and analgesia for labor and delivery, N. Engl. J. Med., 348, pp. 319-332, (2003)

[5]

Lieberman E., Lang J.M., Frigoletto F., Et al., Epidural analgesia, intrapartum fever, and neonatal sepsis evaluation, Pediatrics, 99, pp. 415-419, (1997)

[6]

Goetzl L., Cohen A., Frigoletto F., Lieberman E., Epidural analgesia associated with increased rate of antibiotic use in labor, Am. J. Obstet. Gynecol., 182, (2000)

[7]

Lieberman E., Eichenwald E., Mathur G., Et al., Intrapartum fever and unexplained seizures in term infants, Pediatrics, 106, pp. 983-988, (2000)

[8]

Impey L., Greenwood G., MacQuillan K., Et al., Fever in labour and neonatal encephalopathy: A prospective cohort study, Br. J. Obstet. Gynecol., 108, pp. 594-597, (2001)

[9]

Lieberman E., Lang J., Richardson D.K., Et al., Intrapartum maternal fever and neonatal outcome, Pediatrics, 105, pp. 8-13, (2000)

[10]

Grether J.K., Nelson K.B., Maternal infection and cerebral palsy in infants of normal birth weight, JAMA, 278, pp. 207-211, (1997)

← 1 2 →