Effects of different routes of Dexamethasone on inflammatory factors, intrapartum fever, and pregnancy outcome after epidural labor analgesia
HOU Zhenhuan1 ZHANG Qinglin2
1.Department of Anesthesiology, Tongzhou District Maternal and Child Health Hospital, Beijing 101100, China;
2.Department of Anesthesiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
Abstract：Objective To investigate the effects of different routes of Dexamethasone on inflammatory factors, intrapartum fever, and pregnancy outcome after epidural labor analgesia. Methods A total of 120 primiparas who voluntarily underwent epidural labor analgesia and had a healthy term from Beijing Tongzhou District Maternal and Child Health Hospital and Beijing Obstetrics and Gynecology Hospital, Capital Medical University from September to December 2020 were selected as the research objects. They were divided into epidural group and intravenous group by random number table method, with 60 cases in each group. In the epidural group, 1% Lidocaine Hydrochloride 7-10 ml combined with Dexamethasone 5 mg was pushed into the epidural space, and in intravenous group, 1% Lidocaine Hydrochloride 7-10 ml was pushed into the epidural space and Dexamethasone 5 mg was put into the intravenous pot. The epidural catheter was connected to an electronic pump to adopt patient controlled analgesia model. The levels of interleukin (IL)-6, IL-10, and tumor necrosis factor-α (TNF-α) were compared between two groups before analgesia and 30, 60 min and 24 h after analgesia; intrapartum fever rate, cesarean section rate, and forceps rate were compared between two groups; Apgar scores 1, 5 and 10 min after delivery were compared between two groups. Results Because of failed anesthetic analgesia and immediate cesarean delivery, eight cases were excluded from the epidural group, nine cases were excluded from intravenous group. At 30 and 60 min after analgesia, the levels of IL-6, IL-10, and TNF-α in epidural group were higher than those before analgesia; 24 h after analgesia, the levels of IL-6, IL-10, and TNF-α in epidural group were lower than those at 30 and 60 min after analgesia, and the differences were statistically significant (P＜0.05). At 30 min after analgesia, the levels of IL-6, IL-10, and TNF-α in intravenous group were higher than those before analgesia; at 60 min and 24 h after analgesia, the levels of IL-6, IL-10, and TNF-α in intravenous group were lower than those at 30 min after analgesia, and the differences were statistically significant (P＜0.05). At 30 and 60 min after analgesia, the levels of IL-6, IL-10, and TNF-α in intravenous group were lower than those in epidural group, and the differences were statistically significant (P＜0.05). At 24 h after analgesia, there were no significant differences in the levels of IL-6, IL-10, and TNF-α between two groups (P＞0.05). The intrapartum fever rate in intravenous group was lower than that in epidural group, and the difference was statistically significant (P＜0.05); there was no significant difference in cesarean section rate and forceps delivery rate between two groups (P＞0.05). There were no significant differences in apgar score time, inter-group, and interaction between two groups (P＞0.05). Conclusion Intravenous application of Dexamethasone can effectively reduce the incidence of epidural related labor fever.
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