摘要
目的：探讨剖宫产术后病人硬膜外连续注射局麻药镇痛对泌乳素及婴儿体重的影响。方法：选择６０ 例健康足月产妇，择期在硬膜外麻醉下施行剖宫产术。术毕随机等分为镇痛组和对照组。镇痛组（ ｎ ＝ ３０） 行硬膜外镇痛， 注入０ ．２ ％ 布比卡因（２ ｍｌ／ｈ） 持续７２ｈ 镇痛。对照组（ｎ ＝ ３０ ） 术毕拔出硬膜外导管。两组采用放射免疫分析法测定血浆泌乳素（ Ｐ Ｒ Ｌ） 。结果： 镇痛组 Ｖ Ａ Ｓ 明显低于对照组（ Ｐ ＜ ０ ．０１） 。两组术后 Ｐ Ｒ Ｌ 均较术前明显升高（ Ｐ ＜ ０ ．０１） ，镇痛组术后 Ｐ Ｒ Ｌ 高于对照组，２４ｈ 具有显著性差异（ Ｐ ＜ ０ ．０５） ，４８ ｈ 具有非常显著性差异（ Ｐ ＜ ０ ．０１） 。相关分析表明镇痛组术后２４ ｈ 与４８ ｈ Ｖ Ａ Ｓ 评分均与血浆 Ｐ Ｒ Ｌ 浓度呈负相关（ Ｐ ＜ ０ ．０１） 。镇痛组初乳时间较对照组提前（ Ｐ ＜ ０ ．０５） 。婴儿体重增加明显高于对照组（ Ｐ ＜ ０ ．０５） 。镇痛组肠蠕动恢复时间明显快于对照组（ Ｐ ＜ ０ ．０１） ，镇痛组睡眠好， 但有３ 例一侧肢体麻木。两组宫缩无明显差异（ Ｐ ＞ ０ ．０５） 。结论：剖宫产术后布比卡因硬膜外镇痛能促进 Ｐ Ｒ Ｌ 分泌，增加母乳量及婴儿的?
Objective: The purpose of this study was to determine the effect of postoperative epidural analgesia after cesarean section on the plasma concentration of prolactin and infant weight gain. Method: Sixty healthy parturients at term undergoing elective cesarean section under epidural anesthesia were equelly and randomly allocated to receive or not receive postoperative management epidural bupivacaine (n=30 in analgesia group or control group). Epidural analgesia was performed for 72 hrs with a continuous epidural infusion (2ml/h) of 0.2% bupivacaine. The plasma concentration of prolactin was measured with radioimmunoassay (RIA). Result: (1) VAS pain scores after operation were significantly lower in the analgesia group than in the control group (P<0.01). (2) In both groups prolactin levels were significantly higher after operations (P<0.01). The increase was greater, however, in the analgesia group (P<0.05). (3)There were negative correlations between VAS scores (24h and 48h postoperation) and the plasma concentration of prolactin. (4) Lactation started earlier in analgesia group than in control group (P<0.05). (5) The infant weight gain was more marked in the analgesia group (P<0.05). (6) The duration by which the intestine resumed its motor function was greatly shortened in analgesia group (P<0.01). And patients in analgesia group had better sleep. There were no severe complications except that 3 cases complained numbness of pelvic limbs. No difference was observed in uterus contraction (P>0.05). Conclusion: Continuous epidural bupivacaine after cesarean section produced a satisfactory postoperative pain relief, an increased secretion of prolactin, improvement of breast feeding and a marked gain of infant weight.
出处
《中国疼痛医学杂志》
CAS
CSCD
1999年第3期129-132,共4页
Chinese Journal of Pain Medicine
关键词
镇痛
剖腹产
泌乳素
婴儿体重
硬膜外麻醉
Cesarean section
Epidural analgesia
Bupivacaine
Prolactin
Infant weight
