术后伍用舒芬太尼硬膜外自控镇痛(PCEA)对产妇的泌乳功能的影响

Effects of sufentanial epidural postoperative analgesia on lactation of cesarean patients

目的探讨术后伍用舒芬太尼硬膜外自控镇痛(PCEA)对剖宫产产妇泌乳功能的影响。方法选择180例做剖宫产手术的孕妇,随机分为两组:Ⅰ组(90例)术毕保留硬膜外导管与镇痛泵连接注入镇痛液镇痛。镇痛液配方为舒芬太尼0.4 mg/ml+0.2%罗派卡因+生理盐水至100 ml,负荷剂量3-6 ml,背景速度1.5 ml/h,PCA剂量0.5 ml,锁定时间为15 min;Ⅱ组(90例)视术后疼痛情况间断肌注哌替啶。结果Ⅰ组病人术后止痛效果明显强于Ⅱ组病人,Ⅰ组VAS评分显著低于Ⅱ组(P<0.05),产后24 h内开始分泌乳汁例数及母乳喂养次数Ⅰ组明显高于Ⅱ组(P<0.05);乳汁不足发生率Ⅰ组明显低于Ⅱ组(P<0.05)。结论术后伍用舒芬太尼硬膜外自控镇痛(PCEA)可消除疼痛带来的焦虑、紧张,增加催乳素的分泌,使产妇做到早吸吮,早开奶,提高母乳喂养的成功率。

Objective To discuss the effect of sufentanial epidural postoperative analyesia on lactation of cesarean patients. Methods one bhndred eighty patients of cesarean section were ran domly divided into two groups. Group Ⅰ remained the catheter and received PCEA with sufentanial 0.4 mg/ml ＋ 0.2% ropivacaine：loading dose 3-6 ml,backgroud 1.5 ml/h and bolus of 0.5 ml with lock time 15minutes; Group Ⅱ pull the catheter after operation and inject pethidine. Results The effect of analgesia of group Ⅰ was better than group Ⅱ and the side-effect is little. The women of breast feeding after production in 24h and times breast feeding were much more than group Ⅱ. Conclusion Sufentanial epidural postoperative analgesia can get it out of the anxious, nervous from pain and increase the prolactien and improve the success rate of breast feeding.