摘要
目的:观察剖宫产术后硬膜外自控镇痛产妇的泌乳状况及对血清泌乳素(PRL)的影响。方法:足月初产妇90例均分为三组:Ⅰ组在剖宫产术后采用硬膜外芬太尼、布比卡因自控镇痛(PCEA);Ⅱ组未行术后镇痛;Ⅲ组为阴道自然分娩。采用化学荧光免疫法测定血清泌乳素(PRL)浓度,视觉模拟评分法(VAS)估计镇痛效果,随访72小时。结果:镇痛组VAS明显低于非镇痛组(P<0.01);镇痛组初乳时间明显早于非镇痛组(P<0.05);三组病人产后PRL较产前明显升高(P<0.01),镇痛组术后24小时、48小时PRL明显高于非痛组(P<0.05)。镇痛组睡眠较好,术后MAP、HR平稳,无呼吸抑制等并发症。结论:剖宫产术后采用芬太尼、布比卡因硬膜外PCEA,镇痛效果确切、安全,能增加PRL分泌,促进早泌乳。
Objective :To observe the effects of epidural patient-controlled analgesia( PCEA) with fenta-nyl and bupivacaine on plasma prolactin level after cesarean section. Methods: Ninty maturus primiparous women participated in the study, sixty parturients having undergone elective cesarean section under epidural anesthesia and thirty having natural palturition. The sixty parturients undergone elective cesarean section were randomly and evenly allocated to PCEA group (group Ⅰ) and control group (group Ⅱ). The thirty parturients having natural parturition served as group Ⅲ. In PCEA group received epidural fentanyl and bupivacaine, and in control group without postoperative analgesia. The plasma prolactin levels were determined with radioimmunossay. The analgesic efficacy was evaluated with visual analog scale ( VAS). Results; In PCEA group the VAS score was significantly lower and the colostrum secretion was significantly earlier than those in control group ( P < 0. 01 or P<0.05). The plasma prolactin of the three groups increased markedly 24h and 48 h after cesarean section or parturition compared with those before surgery or parturition( P <0. 01 ). The plasma prolactin level was obviously higher in PCEA group 24h and 48h after cesarean section than control group. In PCEA group, parturients slept well after surgery, MAP HR were kept stable during the whole procedures without respiratory depression and vomiting. Conclusion : Epidural patient-controlled analgesia with fentanyl and bupivacaine is not only safe and effective for postoperative analgesia after cesarean section , but also increase the prolactin secreation to improve maternal colostrum.
出处
《中国疼痛医学杂志》
CAS
CSCD
2003年第2期86-88,共3页
Chinese Journal of Pain Medicine
关键词
镇痛
剖宫产
硬膜外病人自控给药
泌乳素
Analgesia
Cesarean section
Patient-controlled epidural analgesia (PCEA)
Prolactin
