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ISSN: 2644-1403

Global Journal of Anesthesia & Pain Medicine

Research Article(ISSN: 2644-1403)

Effect Of Intrathecal Labor Analgesia On Labor-Induced Endothelial Nitric Oxide Synthase, Tumor Necrosis Factor- Alpha, Interleukin-6, And Neonatal Lactate Levels: A Randomized Controlled Trial Volume 3 - Issue 5

Raden Theodorus Supraptomo*, Suroto, Bambang Purwanto and Ari Natalia Probandari

  • Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia

Received: November 13, 2020;  Published: December 09, 2020

Corresponding author: Raden Theodorus Supraptomo, Department of Anesthesiology and Intensive Care, Dr. Moewardi Hospital, Jalan Kolonel Sutarto No.132, Jebres, Surakarta, Central Java 57126, Indonesia

DOI: 10.32474/GJAPM.2020.03.000175

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Background: Labor pain is the most painful experience. The use of neuraxial intrathecal labor analgesia (ILA) in standard delivery is increasing with lower maternal pain scores and higher levels of satisfaction. This study was aimed to demonstrate that neuraxial ILA mechanisms decrease endothelial nitric oxide synthase (eNOS), and decrease interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α).

Methods: This randomized controlled trial was conducted in 100 pregnant patients, aged <35 years old, who will be in labor within 2017 and were a patient in obstetrics and gynecology at six hospitals and six primary health centers in Surakarta. Subjects were randomized and divided into two groups. Group ILA (n = 50) received 2.5 mg bupivacaine + 50 μg clonidine +0.1 mg morphine and the control group (n = 50) did not receive any treatment. Laboratory findings of eNOS, TNF-α, IL-6, and neonatal lactate levels were recorded.

Results: There was a decrease in TNF-α levels by 44.12%, and in IL-6 levels post-treatment by 74.85% in the treatment group (p<0.05). However, eNOS levels also decreased by 22.87% in the treatment group. There was a difference of 23.40% in lactate levels between the treatment and control groups.

Conclusions: Neuraxial ILA can cause a reduction in TNF-α, IL-6, and neonatal lactate levels and decrease eNOS levels.

Keywords: Analgesia; endothelial nitric oxide synthase; interleukin-6; labor pain; regional anesthesia; TNF-alpha

Abstract| Introduction| Methods| Results| Discussion| Conflicts of Interest| Acknowledgment| Funding Sources| References|