剖宫产术后氢溴酸高乌甲素硬膜外镇痛对产妇泌乳素的影响

目的:观察剖宫产术后应用氢溴酸高乌甲素硬膜外持续镇痛对产妇血浆泌乳素(PRL)的影响。方法:将90例ASAI～Ⅱ足月妊娠的初产妇分为3组,I组经阴道自然分娩;Ⅱ组剖宫产术后病人采用硬膜外持续镇痛泵给予氢溴酸高乌甲素,持续剂量为0.4mg·h-1;Ⅲ组剖宫产术后未行镇痛。采用放射免疫法测定血浆PRL浓度,视觉模拟评分法(VAS)评估镇痛效果。结果:Ⅱ组术后镇痛效果良好,初乳时间均比I、Ⅲ组提前(P<0.05),血浆PRL浓度术前3组间无明显差异;术后24h、48hⅡ组显著性高于I、Ⅲ组(P<0.05),更明显高于术前(P<0.01)。结论:剖宫产术后应用氢溴酸高乌甲素硬膜外持续镇痛效果确切、安全,并能增加PRL分泌,使初乳提前,促进哺乳。

Effect of lappaconitine hydrobromide injection postoperative epidural analgesia on plasma prolactin level in parturients after cesarean section

Objective:To observe the effect of continous epidural analgesia(CEA) with lappaconitine hydrobromide injection on plasma prolactin level after elective cesarean section.Methods:Ninety full-term primiparous women (ASA Ⅰ~Ⅱ)were selected and randomly divided into three groups. Group I, 30 cases were vaginalis natural parturition without any postoperative analgesia. Group II, 30 cases of cesarean section received CEA with lappaconitine hydrobromide injection. Group Ⅲ, 30 cases of cesarean section were without CEA postoperatively as control group. The plasma prolaction level was measured with radioimmunossay.The analgesic effect was evaluated with visual analogue scale (VAS).Results: Analgesia is effective in Group II, the colostrum within 24 h was more earlier in CEA group than that of Group I and Ⅲ (P<0.05).. The plasma prolactin level after cesarean section or parturition was significantly higher in all three groups than those in antepartum, and was significantly higher in group II 24 h and 48 h after parturient than those of group I and III(P<0.05 and P<0.01, respectively).Conclusion:CEA with lappaconitine hydrobromide is a safe and effective method for post-cesarean section analgesia, it increases the prolactin secretion and improves colostrums.