硬膜外自控镇痛对母婴健康的影响

INFLUENCE OF PATIENT-CONTROLLED EPIDURAL ANALGESIA ON HEALTH OF MOTHER AND INFANT

目的 :探讨剖宫产术后芬太尼硬膜外自控镇痛 (PCEA)对产妇和新生儿的影响。方法 :选择 114例硬膜外麻醉剖宫产术的产妇 ,随机分为两组 ,PCEA组 6 0例 ,术毕硬膜外导管连接设置好的PCEA芬太尼混合液装置 ;对照组 5 4例 ,不用PCEA ,疼痛剧烈者于术后当日晚肌注盐酸哌替啶 5 0mg。观察镇痛效果、产妇恢复、母乳喂养及新生儿体重变化情况。结果 :PCEA组的术后 12h镇痛有效率高于对照组 (P <0 0 1)。PCEA组的肠鸣音恢复正常时间、术后下床活动时间、肛门排气时间、产后开始泌乳时间及 2 4h哺乳次数、新生儿体重下降幅度与对照组比较均有显著性差异。结论 :剖宫产术后PCEA芬太尼镇痛效果确切 ,对母婴健康有良好的促进作用 ,值得推广应用。

Objective:To study the influence of fentanyl for patient-controlled epidural analgesia (PCEA) on the pregnant women and the newborn.Methods:114 cases of epidural cesarean section women were selected and randomly divided into two groups,PCEA group (PG) of 60 cases with PCEA set connected to epidural cannula,and control group (CE) of 54 cases without PCEA,who received pethidine 50 mg prn on the operation night.Results:The effective rate of analgesia 12 hours after operation is 90% with 9.26% higher than that of CG,and the difference is significant (P<0.01).There are significant differences in the time of recorery of peristaltic movement,of getting up for activities after operation,of passing flatus through anus,of beginning secreting breast-milk,and the frequency of breast-feeding during 24 h,the range of weight reduction of the newborn between the two groups.Conclusion:The effect of PCEA with fentany1 after cesarean section is reliable.It can promote rehabilitation of mother and infant and is worth spreading and putting into use.