Serum levels of nitric oxide metabolites during labour with or without combined spinal-epidural analgesia

Eur J Anaesthesiol. 2008 Sep;25(9):708-13. doi: 10.1017/S0265021508004298. Epub 2008 May 9.

Abstract

Background and objective: Combined spinal-epidural analgesia is effective in labour analgesia. Nitric oxide may play important roles in pregnancy and labour and is probably affected by labour pain. The aim of the present study was to explore the alteration in serum levels of nitric oxide metabolites, i.e. nitrate and nitrite, during labour with or without combined spinal-epidural analgesia.

Methods: Fifty pregnant women were recruited at the cervical dilatation of 3 approximately 4 cm, 25 received combined spinal-epidural analgesia and 25 served as control. Twenty in the combined spinal-epidural analgesia group and 19 in the control group finished data collection and were included in the analysis. Blood samples were taken at study entry, full cervical dilation and 2 h after delivery. Total serum level of nitrite and nitrate was measured with enzymatic conversion and followed by Griess reaction. Visual analogue pain scores and mean blood pressure were monitored.

Results: After analgesia, pain score and mean blood pressure were significantly lower in the combined spinal-epidural analgesia group than in the control group (P 0.05) but significantly different at full cervical dilation and 2 h after delivery (P 0.05).

Conclusions: Combined spinal-epidural analgesia provided effective analgesia and abolished the decrease in nitric oxide metabolites during active labour.

MeSH terms

  • Adult
  • Anesthesia, Epidural / methods
  • Anesthesia, Obstetrical / methods
  • Anesthesia, Spinal / methods
  • Delivery, Obstetric / methods
  • Female
  • Humans
  • Labor, Obstetric / blood*
  • Nitrates / blood*
  • Nitric Oxide / metabolism*
  • Nitrites / blood*
  • Pain Measurement
  • Pregnancy
  • Treatment Outcome

Substances

  • Nitrates
  • Nitrites
  • Nitric Oxide