剖宫产术后硬膜外镇痛的效果及对泌乳和肠蠕动的影响

Clinical efficacy of patient-controlled epidural analgesia after caesarean section and its impact on laction and enterokinesia

目的观察剖宫产术后硬膜外镇痛（PCEA）的效果及对泌乳和肠蠕动的影响。方法选择足月妊娠的剖宫产患者40例,年龄21~37岁。手术结束时随机分成两组,即试验组（PCEA）和对照组（术后按需肌注哌替啶）,每组20例。试验组术后硬膜外镇痛（PCEA）,对照组拔出硬膜外导管,术后按需肌注哌替啶50 mg/次。结果试验组（PCEA）术后各时点的VAS评分比对照组低（P〈0.01）,镇静评分比对照组高（P〈0.01）。初次泌乳时间和肛门排气时间,PCEA组明显早于对照组（P〈0.05）。结论 PCEA不但镇痛完全,而且又能增加泌乳素（PRL）的分泌,促进产妇早泌乳和胃肠道功能的恢复,无不良反应,是剖宫产手术较好的术后镇痛方法。

Objective To study the clinical efficacy of patient-controlled epidural analgesia（PCEA） after caesarean section and its impact on lactation and enterokinesia.Methods Forty pregnant women（aged 21~37 years old） with full-term gestation undergoing caesarean operation were randomly divide into the study group and the control group,each with 20 cases.Patients in the study group were treated by PCEA after caesarean section,while those in the control group were given intramuscular injections of pethidine 50 mg/times according to need.Results Compared with the control group,the study group has lower postoperative VAS scores at different time points（P〈0.01）,higher analgesia scores（P0.01）,markedly earlier frist lactation and anal exsufflation（P〈0.05）.Conclusion PCEA after caesarean section not only results in complete analgesia,but also increases the secretion of lactation,promotes earlier lactation and the recovery of gastrointestinal functions,showing no adverse reactions,which serves as a worth-adopting method for postoperative analgesia.