Objective To evaluate the safety and efficacy of intravenous magnesium sulfate on maternal intrapartum fever in parturients with preeclampsia undergoing epidural labor analgesia.
Methods A total of 125 parturients diagnosed preeclampsia, with a singleton fetus in vertex presentation, aged 23-33 years, BMI 23-29 kg/m2 , ASA physical status Ⅱ or Ⅲ, were randomly allocated into magnesium group (group M, n = 66) and control group (group C, n = 59). Group M received intravenous magnesium sulfate 50 mg/kg within 20 minutes prior to labor analgesia. Group C received the same volume of intravenous 5 % glucose within 20 minutes prior to labor analgesia. After that epidural labor analgesia was administered in both groups. Maternal tympanic temperature, febrile rate and visual analogue score (VAS) were evaluated at the beginning of analgesia, 1, 2, 3, 4, and 5 hours post analgesia and parturition. Maternal serum interleukin 6(IL-6) levels were also obtained at the beginning of analgesia, 2 hours post analgesia and parturition. Adverse effects such as labor duration, delivery mode, oxytocin dosage, postpartum hemorrhage, analgesic consumption, analgesic time, and 1 and 5 minutes Apgar scores of noenatus were also recorded.
Results Compared with the beginning of analgesia, tympanic temperature in group M rose significantly at 4 and 5 hours after analgesia and parturition, tympanic temperature in group C rose significantly at 3, 4, and 5 hours after analgesia and parturition (P < 0.05),VAS scores at 1, 2, 3, 4, 5 hours post analgesia, and parturition decreased significantly in two groups after labor analgesia (P < 0.05), and serum IL-6 levels showed a significant rise in two groups 2 hours after analgesia and parturition (P < 0.05). Compared with group C, tympanic temperature in group M were lower than those in group C 5 hours after analgesia and parturition (P < 0.05), serum IL-6 levels in group M were significantly lower 2 hours after analgesia (P < 0.05), and group M got less usage of analgesic consumption (P < 0.05). There were no significant differences between two groups in febrile rate, VAS scores, labor duration, delivery mode, oxytocin dosage, postpartum hemorrhage, Apgar scores of neonatus, analgesic time, and adverse effects.
Conclusion Prophylactic intravenous magnesium sulphate 50 mg/kg may safely attenuate maternal tympanic temperature rises in parturients with preeclampsia undergoing epidural labor analgesia. |
