The effect on maternal temperature of delaying initiation of the epidural component of combined spinal-epidural analgesia for labor: a pilot study

Abstract Background Labor epidural analgesia is associated with maternal hyperthermia. This pilot study compared the effects on maternal temperature during labor of different timing of initiation of the epidural component of combined spinal–epidural analgesia. Methods After induction of analgesia with intrathecal bupivacaine 2mg and fentanyl 20μg, healthy term nulliparas in spontaneous labor were randomized to receive immediate epidural analgesia ( n =26) or delayed epidural analgesia after the return of pain ( n =28), by patient-controlled epidural analgesia with 0.125% bupivacaine and fentanyl 1μg/mL. Maternal tympanic temperature, visual analog scale pain score and dermatome block level were measured hourly during labor. Results The duration of labor for most parturients (83.3%) was P =0.03) and the dermatome block level was lower ( P =0.005) in the delayed epidural analgesia group compared to the immediate epidural analgesia group. Conclusions Delaying the epidural component of combined spinal–epidural analgesia did not significantly affect maternal temperature in the study population of whom 83.3% had a labor of