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

Xianjin Zhou, Jiang Li, Shengqiong Deng, Zhendong Xu, Zhiqiang Liu, Xianjin Zhou, Jiang Li, Shengqiong Deng, Zhendong Xu, Zhiqiang Liu

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.

Keywords: IL-6; TNF-α; epidural anesthesia; intrapartum fever; ropivacaine; second stage labor time.

Figures

Figure 1.
Figure 1.
Concentration changes of IL-6 in serum at different time-points in the two groups (ng/l). There was no significant difference in IL-6 concentration between the experimental and control groups at T1 and T3 (P>0.05). However, IL-6 concentration in the experimental group was significantly lower than that in the control group at T2 (P

Figure 2.

Concentration changes of TNF-α in…

Figure 2.

Concentration changes of TNF-α in serum at different time-points in the two groups…

Figure 2.
Concentration changes of TNF-α in serum at different time-points in the two groups (ng/l). There was no significant difference in TNF-α concentration between the experimental and control groups at T1 and T3 (P>0.05). However, TNF-α concentration in the experimental group was significantly lower than that in the control group at T2 (P
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Figure 2.
Figure 2.
Concentration changes of TNF-α in serum at different time-points in the two groups (ng/l). There was no significant difference in TNF-α concentration between the experimental and control groups at T1 and T3 (P>0.05). However, TNF-α concentration in the experimental group was significantly lower than that in the control group at T2 (P

References

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    1. Palm S, Gertzen W, Ledowski T, Gleim M, Wulf H. Minimum local analgesic dose of plain ropivacaine vs. ropivacaine combined with sufentanil during epidural analgesia for labour. Anaesthesia. 2001;56:526–529. doi: 10.1046/j.1365-2044.2001.02050.x.
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