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Acetaminophen didn't prevent epidural-associated fever in study. (Inflammation May Be the Culprit).
HILTON HEAD, S.C. -- If you're looking for a prophylactic measure to help reduce the risk of maternal fever following epidural analgesia, don't count on acetaminophen, Dr. Laura Goetzl reported during the annual meeting of the Society for Obstetric Anesthesia and Perinatology.
The nonopioid analgesic appears to make no dent in the risk of maternal fever following epidural administration.
In clinical trials, epidural analgesia has been associated with a four- to fivefold increase in the likelihood of a patient developing maternal fever, with the highest risk occurring in nulliparous patients.
Such fevers are costly because they trigger an excessive neonatal sepsis evaluation. At the same time, maternal intra-partum fever has been associated with a fourfold increased risk of neonatal seizures.
And there's also evidence that intrapartum fever lowers the threshold to hypoxic insult, said Dr. Goetzl of Baylor College of Medicine, Houston.
In a controlled trial, 42 term nulliparous patients who had no fever before receiving an epidural were randomly assigned to receive rectal suppositories of 650 mg of acetaminophen or a placebo after epidural placement and every 4 hours afterwards.
There was no difference between groups in the rate of maternal fever; 24% in each group developed intrapartum fever.
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