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已发表论文
罗哌卡因和舒芬太尼中添加利多卡因用于硬膜外分娩镇痛：一项关于硬膜外相关产妇发热发生率的随机双盲研究
Authors Shen Y, Hou L, Shen B, Qian J, Xiao F , Yan H
Received 5 September 2025
Accepted for publication 29 November 2025
Published 24 December 2025 Volume 2025:19 Pages 11547—11555
DOI https://doi.org/10.2147/DDDT.S565516
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Yan Zhu
Yanping Shen,1 Lei Hou,2 Bei Shen,3 Jing Qian,4 Fei Xiao,1,4 Haiya Yan1
1Department of Anesthesiology, the Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, Zhejiang, People’s Republic of China; 2Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; 3Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 4Department of Anesthesiology, Jiaxing University Affiliated Women and Children Hospital, Jiaxing, Zhejiang, People’s Republic of China
Correspondence: Fei Xiao, Department of Anesthesiology, the Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, Zhejiang, People’s Republic of China, Email 13706597501@163.com Haiya Yan, Department of Anesthesiology, the Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, Zhejiang, People’s Republic of China, Email nbyanhaiya@sina.com
Background: Epidural-related maternal fever (ERMF) is a common complication of labour analgesia. In vitro evidence suggests ropivacaine provokes inflammatory cytokine release, while lidocaine may exert anti-inflammatory effects. We hypothesized that the addition of lidocaine to a ropivacaine-based epidural solution would reduce the incidence of ERMF.
Methods: In this randomised, double-blind trial, 400 parturients received epidural analgesia with 0.075% ropivacaine and 0.5 μg/mL sufentanil, with or without 0.5% lidocaine. The primary outcome was the incidence of ERMF (tympanic temperature ≥ 38.0°C).
Results: ERMF incidence was significantly lower in the lidocaine group (14.1%) than in the control group (28.3%), with an absolute risk reduction of 14.2% (95% CI: 5.6– 22.7; P=0.0013). No significant differences were found in maternal antibiotic use or neonatal sepsis evaluations.
Conclusion: The addition of lidocaine to ropivacaine for epidural labour analgesia significantly reduced the incidence of ERMF. This finding suggests a simple and promising strategy for preventing this common complication, warranting further investigation into its mechanisms and clinical utility.
Keywords: analgesia, epidural, fever, labour pain, lidocaine, ropivacaine
1Department of Anesthesiology, the Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, Zhejiang, People’s Republic of China; 2Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; 3Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 4Department of Anesthesiology, Jiaxing University Affiliated Women and Children Hospital, Jiaxing, Zhejiang, People’s Republic of China
Correspondence: Fei Xiao, Department of Anesthesiology, the Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, Zhejiang, People’s Republic of China, Email 13706597501@163.com Haiya Yan, Department of Anesthesiology, the Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, Zhejiang, People’s Republic of China, Email nbyanhaiya@sina.com
Background: Epidural-related maternal fever (ERMF) is a common complication of labour analgesia. In vitro evidence suggests ropivacaine provokes inflammatory cytokine release, while lidocaine may exert anti-inflammatory effects. We hypothesized that the addition of lidocaine to a ropivacaine-based epidural solution would reduce the incidence of ERMF.
Methods: In this randomised, double-blind trial, 400 parturients received epidural analgesia with 0.075% ropivacaine and 0.5 μg/mL sufentanil, with or without 0.5% lidocaine. The primary outcome was the incidence of ERMF (tympanic temperature ≥ 38.0°C).
Results: ERMF incidence was significantly lower in the lidocaine group (14.1%) than in the control group (28.3%), with an absolute risk reduction of 14.2% (95% CI: 5.6– 22.7; P=0.0013). No significant differences were found in maternal antibiotic use or neonatal sepsis evaluations.
Conclusion: The addition of lidocaine to ropivacaine for epidural labour analgesia significantly reduced the incidence of ERMF. This finding suggests a simple and promising strategy for preventing this common complication, warranting further investigation into its mechanisms and clinical utility.
Keywords: analgesia, epidural, fever, labour pain, lidocaine, ropivacaine