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Int J Clin Exp Med 2013;6(5):334-341
Original Article
Continuous spinal anesthesia with sufentanil in labor analgesia can induce maternal
febrile responses in puerperas
Fubo Tian, Kai Wang, Jianying Hu, Yi Xie, Shen Sun, Zui Zou, Shaoqiang Huang
Department of Anesthesiology, Shanghai Obstetrics and Gynecology Hospital, Fudan University, 128 Shenyang Road, Shanghai
200090, China; Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road,
Shanghai 200003, China; Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical College, 99 West Huaihai Road, Xuzhou
221006, China. These authors contribute equally to this work.
Received March 24, 2013; Accepted April 13, 2013; Epub May 22, 2013; Published June 1, 2013
Abstract: Several studies documented persistent hypothermia in parturients after spinal anesthesia, while others reported that labor
analgesia was related to a high incidence of fever. Continuous spinal labor anesthesia with sufentanil (CSLAS) is a new effective
technique in labor analgesia but whether it affects maternal temperature has not been clarified. The aim of our study was to explore the
relationship between CSLAS and maternal intrapartum temperature during vaginal delivery. Methods: 75 healthy term nulliparas of
spontaneous labor were randomized to receive CSLAS during delivery in sufentanil group (n=37) or non-pharmacological methods of
pain relief in control group (n=38). The maternal tympanic temperature was recorded at each time points we required during labor. IL-6,
IL-8 and TNF-α were sampled at baseline (before analgesia) and 5 minutes after delivery. The data on visual analog scale (VAS) in all
puerperas, first and second stage durations of labor, vaginal examination, oxytocin augmentation, maternal and neonatal antibiotic
therapy, maternal and neonatal infection, need for cesarean section, need for instrumental delivery and Apgar scores were all collected
from the patients’ medical records. Result: Baseline characteristics of parturients in the 2 groups were not significant differences. After
intrathecal injection of sufentanil, the sensation of pain was attenuated by a wide margin in the sufentanil group compared with the
control group. Nine parturients in the sufentanil group (24.32%) and two in the control group (5.26%) had a tympanic temperature above
38°C during the labor (p=0.024). In each group, there was a tendency that maternal temperature elevated gradually with time elapsing
and reached the peak value 5 hours after baseline. The changes had significant difference from 3 hours to 7 hours after analgesia
compared with baseline. Maternal serum IL-6 and IL-8 levels were increased during the labor, while TNF-α did not vary at any time point
in each group. 1 min and 5 min Apgar scores were not significant difference in the two groups and no neonate developed temperature
above 38°C in the first 24 hours and with antibiotic therapy. Conclusion: The technique of continuous sufentanil spinal labor anesthesia
is a safe and effective method in labor analgesia; however, it is associated with an increased incidence of maternal fever.
(IJCEM1303020).
Keywords: Analgesia, sufentanil, continuous spinal labor anesthesia, CSLAS, maternal temperature, fever, labor pain
Address correspondence to: Dr. Shaoqiang Huang, Department of Anesthesiology, Shanghai Obstetrics and Gynecology Hospital,
Fudan University, 128 Shenyang Road, Shanghai 200090, China. Phone: +86-21-63455050-6868; Fax: +86-21-63455090; E-mail:
timrobbins71@163.com; Dr. Zui Zou, Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, 415
Fengyang Road, Shanghai 200003, China. Phone: +86-21-81886999; Fax: +86-21-63520020; E-mail: zouzui1980@yahoo.com.cn
Original Article
Continuous spinal anesthesia with sufentanil in labor analgesia can induce maternal
febrile responses in puerperas
Fubo Tian, Kai Wang, Jianying Hu, Yi Xie, Shen Sun, Zui Zou, Shaoqiang Huang
Department of Anesthesiology, Shanghai Obstetrics and Gynecology Hospital, Fudan University, 128 Shenyang Road, Shanghai
200090, China; Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road,
Shanghai 200003, China; Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical College, 99 West Huaihai Road, Xuzhou
221006, China. These authors contribute equally to this work.
Received March 24, 2013; Accepted April 13, 2013; Epub May 22, 2013; Published June 1, 2013
Abstract: Several studies documented persistent hypothermia in parturients after spinal anesthesia, while others reported that labor
analgesia was related to a high incidence of fever. Continuous spinal labor anesthesia with sufentanil (CSLAS) is a new effective
technique in labor analgesia but whether it affects maternal temperature has not been clarified. The aim of our study was to explore the
relationship between CSLAS and maternal intrapartum temperature during vaginal delivery. Methods: 75 healthy term nulliparas of
spontaneous labor were randomized to receive CSLAS during delivery in sufentanil group (n=37) or non-pharmacological methods of
pain relief in control group (n=38). The maternal tympanic temperature was recorded at each time points we required during labor. IL-6,
IL-8 and TNF-α were sampled at baseline (before analgesia) and 5 minutes after delivery. The data on visual analog scale (VAS) in all
puerperas, first and second stage durations of labor, vaginal examination, oxytocin augmentation, maternal and neonatal antibiotic
therapy, maternal and neonatal infection, need for cesarean section, need for instrumental delivery and Apgar scores were all collected
from the patients’ medical records. Result: Baseline characteristics of parturients in the 2 groups were not significant differences. After
intrathecal injection of sufentanil, the sensation of pain was attenuated by a wide margin in the sufentanil group compared with the
control group. Nine parturients in the sufentanil group (24.32%) and two in the control group (5.26%) had a tympanic temperature above
38°C during the labor (p=0.024). In each group, there was a tendency that maternal temperature elevated gradually with time elapsing
and reached the peak value 5 hours after baseline. The changes had significant difference from 3 hours to 7 hours after analgesia
compared with baseline. Maternal serum IL-6 and IL-8 levels were increased during the labor, while TNF-α did not vary at any time point
in each group. 1 min and 5 min Apgar scores were not significant difference in the two groups and no neonate developed temperature
above 38°C in the first 24 hours and with antibiotic therapy. Conclusion: The technique of continuous sufentanil spinal labor anesthesia
is a safe and effective method in labor analgesia; however, it is associated with an increased incidence of maternal fever.
(IJCEM1303020).
Keywords: Analgesia, sufentanil, continuous spinal labor anesthesia, CSLAS, maternal temperature, fever, labor pain
Address correspondence to: Dr. Shaoqiang Huang, Department of Anesthesiology, Shanghai Obstetrics and Gynecology Hospital,
Fudan University, 128 Shenyang Road, Shanghai 200090, China. Phone: +86-21-63455050-6868; Fax: +86-21-63455090; E-mail:
timrobbins71@163.com; Dr. Zui Zou, Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, 415
Fengyang Road, Shanghai 200003, China. Phone: +86-21-81886999; Fax: +86-21-63520020; E-mail: zouzui1980@yahoo.com.cn
