摘要
目的观察剖宫产术后高乌甲素患者自控静脉镇痛(PCIA)的临床效果和它对孕妇血浆催乳素(PRL)的影响。方法29例择期行剖宫产术孕妇,随机分成镇痛组(n=14)和对照组(n=15)。镇痛组在剖宫产术后,采用PCIA给予氢溴酸高乌甲素,持续剂量0.4mg/h,PCA剂量为0.1mg。镇痛时间40h。以放射免疫法测血浆PRL浓度,视觉模拟评分法(VAS)评估镇痛效果,对照组术后疼痛时肌注哌替啶。结果镇痛组VAS明显低于对照组(P<0.01);镇痛组初乳时间明显早于对照组(P<0.05);两组产妇术后24h血浆PRL浓度明显高于术前(P<0.01),镇痛组的术后24h血浆PRL浓度明显高于对照组(P<0.05),镇痛组术后心率、血压平稳,无皮肤瘙痒、呼吸抑制及呕吐发生。结论剖宫产术后采用高乌甲素PCIA,镇痛效果确切安全,PRL分泌增加,初乳提前,可促进哺乳。
Objective To observe the analgesic efficacy of intravenous patient-controlled analgesia(PCIA) with Lappaconitine and its influence on plasma prolactin level after Cesarean section. Methods Twenty-nine parturients undergoing elective Cesarean section under epidural anesthesia, were randomly allocated to PCIA group (n=14) and control group (n=15). In PCIA group, intravenous Lappaconitine was administered at rate of 0.4mg/h with bolus dose of 0.1 mg beyond 15 min period. Pethidine was injected 1M when postoperative pain appeared in control group without postoperative analgesia. The plasma prolactin levels was determined with radioimmunoassay. The analgesic efficacy was evaluated with visual analogue scale (VAS). Results In PCIA group the VAS score was significantly lower (P<0.01) and the colostrum secretion was more early than those in control group (P<0.05 ). The plasma levels of prolactin of both groups increased significantly 24 h after Cesarean section compared with those before surgery (P<0.01). The plasma prolactin level was significantly higher in PCIA group 24 h after Cesarean section than control level (P<0.05). Heart rate and blood pressure were kept stable during whole procedure without respiratory depression and vomiting. Conclusion Intravenous patient-controlled analgesia with Lappaconitine is not only safe and effective for postoperative analgesia after Cesarean section, but also increase the prolactin secreation to improve maternal colostrum.
出处
《实用疼痛学杂志》
2005年第1期14-16,共3页
Pain Clinic Journal
