Labor epidural analgesia and maternal fever.


:Women in labor who receive epidural analgesia are more likely to experience hyperthermia and overt clinical fever. The gradual development of modest hyperthermia observed in laboring women with epidural analgesia is not seen in those electing other forms of analgesia or unmedicated labor. Clinical fever is also far more likely in women laboring with epidural analgesia. It is possible that the observed slow increase in mean temperature is an artifact of averaging the temperature curves of a small group of women who eventually develop fever with a larger group who remain afebrile throughout labor. Selection bias confounds the association between epidural analgesia and fever, because women at risk for fever-due to longer duration of ruptured membranes, longer labor, more frequent cervical examinations, and other interventions-are also more likely to select epidural analgesia. However, even randomized trials have confirmed a higher incidence of fever in epidural-exposed women, suggesting a causal relationship. The mechanisms of epidural-associated fever remain incompletely understood. Altered thermoregulation and an antipyretic effect of opioids given to women without epidural analgesia may explain part of the phenomenon, but the most likely etiology is inflammation, most commonly in the placenta and membranes (chorioamnionitis). The consequences of maternal fever are diverse. Obstetricians are more likely to intervene surgically in laboring women with fever, and neonatologists are more likely to evaluate neonates of febrile women for sepsis. More ominously, maternal inflammatory fever is associated with neonatal brain injury, manifest as cerebral palsy, encephalopathy, and learning deficits in later childhood. At present, there are no safe and effective means to inhibit epidural-associated fever. Future research should define the etiology of this fever and search for safe and effective interventions to prevent it and to inhibit its potential adverse effects on the neonatal brain.


Anesth Analg


Anesthesia and analgesia


Segal S




Has Abstract


2010-12-01 00:00:00














  • Diagnostic Accuracy of Point-of-Care Gastric Ultrasound.

    abstract:BACKGROUND:Pulmonary aspiration of gastric contents is associated with significant perioperative morbidity and mortality. Previous studies have investigated the validity, reliability, and possible clinical impact of gastric ultrasound for the assessment of gastric content at the bedside. In the present study, we examin...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Kruisselbrink R,Gharapetian A,Chaparro LE,Ami N,Richler D,Chan VWS,Perlas A

    更新日期:2019-01-01 00:00:00

  • Anesthetic and hemodynamic effects of single bolus versus incremental titration of hyperbaric spinal lidocaine through microcatheter.

    abstract::This study examined anesthetic development and hemodynamic changes during two techniques of hyperbaric lidocaine administration through 27-gauge intrathecal catheters for continuous spinal anesthesia in 55 elderly patients undergoing transurethral prostatic resection. Twenty-five patients were randomly assigned to rec...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Chan VW,Chung F,Gomez M,Seyone C,Baylon G

    更新日期:1994-07-01 00:00:00

  • Intraoperative patient-controlled analgesia: an alternative to physician administration during outpatient monitored anesthesia care.

    abstract::Outpatients undergoing minor diagnostic and therapeutic procedures associated with intermittent discomfort are frequently given bolus injections of intravenous opioid analgesics. In a group of 80 healthy women undergoing vaginal ovum pickup procedures, we evaluated patient-controlled administration of alfentanil using...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章


    authors: Zelcer J,White PF,Chester S,Paull JD,Molnar R

    更新日期:1992-07-01 00:00:00

  • Lecture practices in United States anesthesiology residencies.

    abstract::We obtained data on lecture practices from 100 of the 110 university-affiliated anesthesiology residency programs certified in the United States in 1988. Of these residency programs, 36% had a majority of their lectures before the operating room schedule began, 57% had no lectures at all in this early time slot, and 7...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Landers DF,Becker GL,Newland MC,Peters KR

    更新日期:1992-01-01 00:00:00

  • Intrathecal versus intravenous fentanyl for supplementation of subarachnoid block during cesarean delivery.

    abstract:UNLABELLED:Forty-eight healthy parturients scheduled for elective cesarean delivery were randomly allocated to receive intrathecally either 12 mg of hyperbaric bupivacaine plus 12.5 microg of fentanyl (n = 23) or bupivacaine alone (n = 25). In the latter group, IV 12.5 microg of fentanyl was administered immediately af...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Siddik-Sayyid SM,Aouad MT,Jalbout MI,Zalaket MI,Berzina CE,Baraka AS

    更新日期:2002-07-01 00:00:00

  • Special article: airway management in reconstructive surgery for noma (cancrum oris).

    abstract::Noma (cancrum oris) is a disease of poverty and malnutrition, which predominantly affects children younger than 10 years in developing countries. Although the majority of sufferers die of sepsis at the time of the initial infection, or of subsequent starvation due to severe trismus and an inability to eat, a small min...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Coupe MH,Johnson D,Seigne P,Hamlin B

    更新日期:2013-07-01 00:00:00

  • A manual slide rule for target-controlled infusion of propofol: development and evaluation.

    abstract:UNLABELLED:We describe the development and evaluation of a simple slide rule that enables the bedside determination of the infusion rate for a particular target plasma concentration of propofol. The infusion rate to reach this target concentration at time (t) is the product of the target concentration, body weight, and...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Bruhn J,Bouillon TW,Röpcke H,Hoeft A

    更新日期:2003-01-01 00:00:00

  • Treatments to support blood pressure increases bleeding and/or decreases survival in a rat model of closed head trauma combined with uncontrolled hemorrhage.

    abstract:UNLABELLED:Hemorrhagic hypotension may aggravate the detrimental effects of head trauma on neurologic outcome. Our study examined whether using phenylephrine or large volumes of saline IV to increase mean arterial blood pressure (MAP) to 70, 80, or 90 mm Hg during the combination of head trauma and uncontrolled hemorrh...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Talmor D,Merkind V,Artru AA,Shapiro O,Geva D,Roytblat L,Shapira Y

    更新日期:1999-10-01 00:00:00

  • The use of transcutaneous acupoint electrical stimulation for preventing nausea and vomiting after laparoscopic surgery.

    abstract:UNLABELLED:Nonpharmacologic techniques may be effective in preventing postoperative nausea and vomiting (PONV). This sham-controlled, double-blinded study was designed to examine the antiemetic efficacy of transcutaneous acupoint electrical stimulation (TAES) in a surgical population at high risk of developing PONV. We...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Zárate E,Mingus M,White PF,Chiu JW,Scuderi P,Loskota W,Daneshgari V

    更新日期:2001-03-01 00:00:00

  • The effect of peripheral opioid block and body cooling on sensitivity to heat in capsaicin-treated skin.

    abstract:UNLABELLED:We sought to determine whether stimulation of opioid receptors during body cooling would alter sensitivity to heat in the heat-sensitized, inflamed skin of 14 healthy volunteers. To investigate the contribution of opioid receptors to nociception, the opioid antagonist naloxone was introduced into the skin by...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Drummond PD

    更新日期:2000-04-01 00:00:00

  • Resistance to atracurium-induced neuromuscular blockade in patients with intractable seizure disorders treated with anticonvulsants.

    abstract::Previous studies have demonstrated that, with the exception of atracurium, resistance to the neuromuscular blocking effects of various muscle relaxants develops in patients receiving anticonvulsant therapy. We studied the effects of 0.5 mg/kg IV atracurium in 53 neurosurgical patients: 21 nonepileptic patients receivi...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Tempelhoff R,Modica PA,Jellish WS,Spitznagel EL

    更新日期:1990-12-01 00:00:00

  • Outcomes in Patients Undergoing Cardiac Surgery Who Decline Transfusion and Received Erythropoietin Compared to Patients Who Did Not: A Matched Cohort Study.

    abstract:BACKGROUND:Erythropoiesis-stimulating agents, such as erythropoietin (EPO), can be used to treat preoperative anemia. Some studies suggest an increased risk of mortality and thrombotic events, and use in cardiovascular surgery remains off-label. This study compares outcomes in cardiac surgery patients declining blood t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Duce L,Cooter ML,McCartney SL,Lombard FW,Guinn NR

    更新日期:2018-08-01 00:00:00

  • Distribution of Extreme Vital Signs and Complete Blood Count Values of Healthy Parturients: A Retrospective Database Analysis and Review of the Literature.

    abstract:BACKGROUND:The impact of physiological adjustments throughout pregnancy on maternal vital signs and laboratory values has yet to be fully defined. The present study was designed to determine the normal range of these parameters among healthy pregnant women during the peripartum period. METHODS:This is a retrospective ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审


    authors: Gat R,Hadar E,Orbach-Zinger S,Shochat T,Kushnir S,Einav S

    更新日期:2019-12-01 00:00:00

  • Intraarticular tramadol-bupivacaine combination prolongs the duration of postoperative analgesia after outpatient arthroscopic knee surgery.

    abstract:BACKGROUND:Intraarticular (IA) local anesthetics are often used for the management and prevention of pain after arthroscopic knee surgery. Recently, IA tramadol was also used for the management of these patients. However, the IA combination of local anesthetic and tramadol has not been evaluated in arthroscopic outpati...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Zeidan A,Kassem R,Nahleh N,Maaliki H,El-Khatib M,Struys MM,Baraka A

    更新日期:2008-07-01 00:00:00

  • Performance of certified registered nurse anesthetists and anesthesiologists in a simulation-based skills assessment.

    abstract:BACKGROUND:Anesthesiologists and certified registered nurse anesthetists (CRNAs) must acquire the skills to recognize and manage a variety of acute intraoperative emergencies. A simulation-based assessment provides a useful and efficient means to evaluate these skills. In this study, we evaluated and compared the perfo...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Henrichs BM,Avidan MS,Murray DJ,Boulet JR,Kras J,Krause B,Snider R,Evers AS

    更新日期:2009-01-01 00:00:00

  • Intraoperative hemodynamic, renin, and catecholamine responses after prophylactic and intraoperative administration of intravenous enalaprilat.

    abstract::This study was designed to evaluate effects of enalaprilat, an angiotensin-converting enzyme inhibitor, on hemodynamic and hormonal responses during surgery at endotracheal intubation, incision, and limb-tourniquet inflation. Thirty patients undergoing limb procedures with general anesthesia (N2O/narcotic technique) a...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Heropoulos M,Schieren H,Seltzer JL,Bartkowski RR,Lessin J,Torjman M,Moody C,Goldberg ME

    更新日期:1995-03-01 00:00:00

  • Body temperature change during anesthesia for electroconvulsive therapy: implications for quality incentives in anesthesiology.

    abstract:BACKGROUND:The American Society of Anesthesiologists has announced that perioperative normothermia is a "Quality Incentive in Anesthesiology." We examined whether we could meet this quality incentive in a simple population: patients undergoing anesthesia for electroconvulsive therapy (ECT). METHODS:We compared infrare...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Modell JH,Gravenstein N,Morey TE

    更新日期:2008-11-01 00:00:00

  • Inhibiting a spinal dynorphin A component enhances intrathecal morphine antinociception in mice.

    abstract::Morphine given intracerebroventricularly releases spinal dynorphin A (Dyn) in mice. The present study was undertaken to determine whether morphine given intrathecally (IT) released Dyn. We demonstrated that the antinociceptive action of morphine was enhanced by procedures that are known to attenuate Dyn action. First,...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Holmes BB,Fujimoto JM

    更新日期:1993-12-01 00:00:00

  • Synergy between pairs of competitive antagonists at adult human muscle acetylcholine receptors.

    abstract:BACKGROUND:Synergistic neuromuscular blocking effects have been observed clinically with certain pairs of nicotinic acetylcholine receptor (nAChR) competitive antagonists. The mechanism for synergy has not been elucidated. We tested the hypothesis that synergy arises from a differential selectivity of antagonists for t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Liu M,Dilger JP

    更新日期:2008-08-01 00:00:00

  • Systemic physostigmine shows antiallodynic effects in neuropathic rats.

    abstract:UNLABELLED:The aim of this study was to examine the antiallodynic and antinociceptive effects of subcutaneously administered physostigmine (50, 100, 200 micrograms/kg), compared with morphine (2.5, 5, 10 mg/kg) and NaCl after spinal nerve ligation in rats. The following stimuli were used: acetone (cold allodynia), von ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Pöyhiä R,Xu M,Kontinen VK,Paananen S,Kalso E

    更新日期:1999-08-01 00:00:00

  • Effect of volatile anesthetics on vecuronium-induced neuromuscular blockade in children.

    abstract::We studied 60 children undergoing elective surgery to evaluate the effect of interactions between vecuronium and isoflurane or halothane on the potency and duration of neuromuscular blockade, as measured by electromyography. Vecuronium was first administered by a logarithm-based cumulative method (14, 22, 35, 56, 89 m...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Pittet JF,Melis A,Rouge JC,Morel DR,Gemperle G,Tassonyi E

    更新日期:1990-03-01 00:00:00

  • The effect of clonidine on the activity of neurons in the rat dorsal raphe nucleus in vitro.

    abstract::The dorsal raphe (DR) nucleus is a system of nuclei in the midline of the lower brainstem, which is considered one of the most important nuclei in the modulation of pain in the central nervous system. Central noradrenergic systems play an important role in the control of cardiovascular regulation and pain transmission...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Alojado ME,Ohta Y,Kemmotsu O

    更新日期:1994-08-01 00:00:00

  • Pulse oximetry for perioperative monitoring: systematic review of randomized, controlled trials.

    abstract::Monitoring with pulse oximetry might improve patient outcome by enabling an early diagnosis and, consequently, correction of perioperative events that might otherwise cause postoperative complications or even death. The aim of the study was to clarify the effect of perioperative monitoring with pulse oximetry and to i...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,meta分析


    authors: Pedersen T,Møller AM,Pedersen BD

    更新日期:2003-02-01 00:00:00

  • The effects of propofol on hemodynamics and renal blood flow in healthy and in septic sheep, and combined with fentanyl in septic sheep.

    abstract::Sepsis is characterized by myocardial depression and systemic vasodilation, both of which are most likely mediated by nitric oxide. Propofol inhibits nitric oxide synthase and may therefore be beneficial in sepsis. On the other hand, renal blood flow, known to be only minimally affected by propofol in healthy subjects...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Booke M,Armstrong C,Hinder F,Conroy B,Traber LD,Traber DL

    更新日期:1996-04-01 00:00:00

  • A novel infraclavicular brachial plexus block: the lateral and sagittal technique, developed by magnetic resonance imaging studies.

    abstract:UNLABELLED:A new infraclavicular brachial plexus block method has the patient supine with an adducted arm. The target is any of the three cords behind the pectoralis minor muscle. The point of needle insertion is the intersection between the clavicle and the coracoid process. The needle is advanced 0 degrees -30 degree...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章


    authors: Klaastad Ø,Smith HJ,Smedby O,Winther-Larssen EH,Brodal P,Breivik H,Fosse ET

    更新日期:2004-01-01 00:00:00

  • The effect of universal leukodepletion of packed red blood cells on postoperative infections in high-risk patients undergoing abdominal aortic surgery.

    abstract:UNLABELLED:We evaluated, by using a before-and-after study, the influence of leukoreduction by filtration on postoperative infections and adverse outcomes in patients undergoing elective major aortic surgery. From January 1995 to October 2000, all patients who underwent elective abdominal aortic surgery were included i...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Baron JF,Gourdin M,Bertrand M,Mercadier A,Delort J,Kieffer E,Coriat P

    更新日期:2002-03-01 00:00:00

  • A laboratory evaluation of an auditory display designed to enhance intraoperative monitoring.

    abstract:UNLABELLED:Encouraged by the popularity of the pulse oximeter pulse-tone, we developed and tested an auditory display of six physiologic variables. The display consisted of a cardiovascular sound triggered by every heartbeat (conveying heart rate) and a respiratory sound triggered by every breath (conveying respiratory...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Loeb RG,Fitch WT

    更新日期:2002-02-01 00:00:00

  • Differences in production of reactive oxygen species and mitochondrial uncoupling as events in the preconditioning signaling cascade between desflurane and sevoflurane.

    abstract:BACKGROUND:Signal transduction cascade of anesthetic-induced preconditioning has been extensively studied, yet many aspects of it remain unsolved. Here, we investigated the roles of reactive oxygen species (ROS) and mitochondrial uncoupling in cardiomyocyte preconditioning by two modern volatile anesthetics: desflurane...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Sedlic F,Pravdic D,Ljubkovic M,Marinovic J,Stadnicka A,Bosnjak ZJ

    更新日期:2009-08-01 00:00:00

  • American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Patient-Reported Outcomes in an Enhanced Recovery Pathway.

    abstract::Patient-reported outcomes (PROs) are measures of health status that come directly from the patient. PROs are an underutilized tool in the perioperative setting. Enhanced recovery pathways (ERPs) have primarily focused on traditional measures of health care quality such as complications and hospital length of stay. The...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审


    authors: Abola RE,Bennett-Guerrero E,Kent ML,Feldman LS,Fiore JF Jr,Shaw AD,Thacker JKM,Gan TJ,Miller TE,Hedrick TL,McEvoy MD,Mythen MG,Bergamaschi R,Gupta R,Holubar SD,Senagore AJ,Wischmeyer PE,Carli F,Evans DC,Guilbert S,

    更新日期:2018-06-01 00:00:00

  • Recurrence of cardiotoxicity after lipid rescue from bupivacaine-induced cardiac arrest.

    abstract::Accidental intravascular administration of bupivacaine during performance of a brachial block precipitated convulsions followed by asystole. The patient was rapidly resuscitated using cardiopulmonary resuscitation, supplemented by 150 mL of 20% lipid emulsion. Nonetheless, cardiac toxicity reappeared 40 min after comp...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Marwick PC,Levin AI,Coetzee AR

    更新日期:2009-04-01 00:00:00