剖宫产及硬膜外吗啡术后镇痛对产妇泌乳的影响

Effects of Cesarean Section and Postoperative Epidural Morphine Analgesia 3on Lactation in Puerperants

目的：观察剖宫产及硬膜外吗啡术后镇痛产妇的泌乳状况及血清泌乳素（ＰＲＬ）变化。方法：足月初产妇１２０例均分为四组：Ⅰ组术毕行硬膜外吗啡镇痛；Ⅱ组术毕硬膜外吗啡镇痛，２４小时后追加１次；Ⅲ组未行术后镇痛；阴道自然分娩３０例为Ⅳ组。结果：产后５分钟、２４及４８小时ＰＲＬ值变化各组间无显著性差异。Ⅳ组产后２４小时内开始泌乳发生率（４０％），高于同期所有剖宫产组（２０％）；但４８小时内开始泌乳及７２小时乳汁分泌不足发生率与剖宫产组相比无差异。剖宫产三组平均术后镇痛时间明显不同，但各组产妇开始泌乳及乳汁分泌不足发生率均无差异。结论：剖宫产及硬膜外吗啡术后镇痛不影响产妇母乳喂养的成功率。

Objective: The lactational state and change of serum prolactin (PRL) were observed in women undergoing the cesarean section and postoperative epidural morphine analgesia. Methods: 120 maturus primiparous women participated in the study. 90 women underwent cesarean section under epidural anesthesia were divided randomly into three groups. The epidural analgesia with morphine was used in group at the end of the operation. The same way was taken in group at the end of the operation and was repeated 24 h after the operation. The epidural morphine was not administered postoperatively in group . 30 women of natural labor were regarded as group . Results: Among four groups there was no significant difference in PRL levels at 5min, in 24 and 48h postpartum. The incidence of beginning lactation in 24h postpartum was higher in the natural labor group than that in all women undergoing the cesarean section, but the lactation in 48h postpartum and the hypogalactia 72h postpartum in both groups were similar. The average time of postoperative analgesia was significantly different among group , and . Conclusion: Cesarean section and postoperative epidural morphine analgesia would not affect the success rate of breastfeeding.