罗比卡因用于剖宫产术后硬膜外镇痛对产妇泌乳的影响观察

Effects of Ropivacaine Used in Postoperative Epidural Analgesia After Cesarean on Puerpera's Lactation

目的:探讨剖宫产术后病人以罗比卡因行硬膜外镇痛对产妇泌乳的影响。方法:选择ASAⅠ-Ⅱ级,年龄22-35岁在硬膜外麻醉下行剖宫产手术的患者60例,随机分为两组,每组30例。镇痛组术后以罗比卡因行硬膜外镇痛,对照组术后伤口疼痛时肌注哌替啶。采用视觉模拟评分(VAS)估计镇痛效果,记录开始泌乳时间,肛门排气时间,不良反应发生情况。结果:镇痛组VAS评分明显低于对照组(P<0.05),镇痛组初乳时间较对照组提前(P<0.05),镇痛组肠蠕动恢复时间快于对照组(P<0.05)。结论:剖宫产术后用罗比卡因行硬膜外镇痛效果确切、安全,初乳时间提早。

Objective: To determine the effects of ropivacaine used in postoperative epidural analgesia after cesarean on puerpera's lactation. Method: Sixty ASA Ⅰ-Ⅱ patients aged 22-35 years undergoing cesarean under epidural anesthesia were equally and randomly dirided into two groups - analgesia group( n = 30) and controlled group( n = 30) . The analgesia group received epidural analgesia, the controlled group was injected dolantin when pain occured. The analgesia efficacy was evaluated by visual analog scale (VAS). The beginning time of lactation and anus exhaust were recorded. The side effects were also recorded. Result: The VAS score in analgesia group was significantly lower than that in controlled group ( P<0. 05 ). The lactation started earlier in analgesia group than that in controlled group (P<0.05). The duration in which the intestine resumed its peristalsis was greatly quicker in analgesia group than that in the controlled group(P <0.05). Conclusion:The continuous epidural ropivacaine after cesarean could produce a satisfactory and safe postoperative pain relief, the lactation started earlier.