Effect of transcutaneous electrical acupoint stimulation on epidural-related maternal fever in parturients undergoing epidural labor analgesia

Abstract

To evaluate the therapeutic effect and safety of transcutaneous electrical acupoint stimulation (TEAS) on epidural-related maternal fever in parturients undergoing epidural labor analgesia. A total of 198 primiparas with single birth, full-term pregnancy and head position were recruited and randomized into a TEAS group (98 cases) and a control group (100 cases). In the TEAS group, after epidural labor analgesia, TEAS was applied to bilateral Hegu (LI4) and Quchi (LI11), once an hour, for 30 min each time, till the end of childbirth. In the control group, after epidural labor analgesia, TEAS electrodes were attached to the same acupoints, but without electric stimulation. Maternal tympanic temperature and the score of Visual Analogue Score (VAS) were measured before analgesia, at 1, 2, 3, 4 and 5 h after analgesia and during labor respectively and maternal fever rate was evaluated in the parturients of two groups. Separately, before analgesia, 2 h after analgesia and during labor, the levels of serum interleukin (IL-6) and IL-1β were determined in the parturients of two groups. The duration of labor, the mode of labor, oxytocin dosage, postpartum hemorrhage, neonatal Apgar scores, time of labor analgesia, labor analgesic consumption and adverse effects were recorded in the parturients of two groups. Maternal tympanic temperature increased progressively in two groups as analgesic time prolonged. Tympanic temperature at 3, 4 and 5 h after analgesia and du-ring labor, and maternal fever rate during labor in the TEAS group were all lower than those in the control group respectively (P<0.05). The levels of serum IL-6 and IL-1β increased after analgesia in the parturients of two groups. The serum IL-6 level during labor and the level of IL-1β at 2 h after analgesia and during labor in the parturients of the TEAS group were lower than those in the control group (P<0.05). The analgesic consumption in the TEAS group was less than that in the control group (P<0.05). The incidence of chills in the TEAS group was lower than that in the control group (P<0.05). The differences were not statistical in VAS score, duration of labor, mode of labor, oxytocin dosage, postpartum hemorrhage, time of labor analgesia and neonatal Apgar score, as well as the incidence of urine retention, nausea and vomiting and urinary retention between two groups (P>0.05). Transcutaneous electrical acupoint stimulation at LI11 and LI4 is conductive to relieving epidural-rela-ted maternal fever and reducing serum levels of IL-6 and IL-1β in the parturients undergoing epidural labor analgesia. It is safe and effective in clinical application.