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
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
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.