• Caixia Sun, Shujun Ren, Chen Chen, Qin Liu, Peichun Lu, Lin Xia, Donghua Shao, and Jing Xu.
• Department of Anesthesiology, Affiliated People's Hospital of Jiangsu University, Zhenjiang City, Jiangsu Province 212002, China. Electronic address: suncaixia_zj@126.com.
• J Clin Anesth. 2022 Sep 1; 80: 110852.

Study ObjectiveTo assess whether pulse perfusion index (PI) values could be employed to predict intrapartum fever and to provide a cut-off PI value for predicting intrapartum fever occurrence.DesignWe conducted a single-center, prospective, observational study.SettingDelivery room at the Department of Obstetrics, Affiliated Hospital of Jiangsu University.Patients117 parturients who intended to have a vaginal delivery.InterventionsEach parturient received epidural analgesia.MeasurementsWe checked each parturient's tympanic temperature before analgesia (T0), at 1 h (T1) and 2 h (T2) after analgesia, immediately at the end of the second (T3) and third (T4) stages of labor, and at 1 h postpartum (T5). A temperature of ≥38°C was defined as fever. PI, measured on the right second toe, was recorded before analgesia (PI0) and at 10 min (PI10), 20 min (PI20), and 30 min (PI30) after analgesia. The PI change rate was calculated as the incremental change in PI30 from PI0, divided by the PI0. Receiver operating characteristic (ROC) curves were used to verify the utility of the PI30 and PI change rate values for predicting intrapartum fever.Main ResultsWe found that peak temperature (TP) occurred at the end of the second or the third stage of labor. Within 30 min after analgesia, the PI showed a significant increase over time and there was a linear correlation between PI30 and TP values (P < 0.001, r = 0.544). The PI10, PI20, PI30 and PI change rate in febrile parturients were higher than those in afebrile parturients (P < 0.001). The area under the ROC (AUROC) for PI30 was 0.818 (P < 0.001) with a cut-off of 9.30. The AUROC of the PI change rate was 0.738 (P < 0.001) with a cut-off of 3.45.ConclusionsPI30 and PI change rate values could be used to predict intrapartum fever in parturients after epidural analgesia.Copyright © 2022 Elsevier Inc. All rights reserved.

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