盐酸罗派卡因复合舒芬太尼硬膜外术后镇痛对产妇泌乳的影响

目的 探讨盐酸罗派卡因复合舒芬太尼硬膜外术后镇痛对产妇泌乳功能的影响.方法 将82例单胎足月妊娠拟行剖宫产的产妇按随机数字表法分为对照组40例和观察组42例,均采用持续硬膜外麻醉,对照组术后视疼痛情况肌内注射哌替啶,观察组术后接含0.125％盐酸罗派卡因+0.5 μg·mL-1舒芬太尼镇痛液的镇痛泵,行术后硬膜外自控镇痛.结果 观察组产妇的初乳时间早于对照组,且日哺乳次数明显多于对照组,2组相比差异有统计学意义(P＜0.05)；分娩后观察组的泌乳素水平明显升高,与手术前比较,差异有统计学意义(P＜0.05),且明显高于对照组(P＜0.05).结论 采用盐酸罗派卡因复合舒芬太尼硬膜外自控镇痛可明显减少因疼痛引起的泌乳功能下降,对产妇的康复和新生儿母乳喂养有利.

Effects of Ropivacaine Hydrochloride Combined with Sufentanil for Postoperative Epidural Analgesia on Maternal Lactation

Objective To investigate the effects of ropivacaine hydrochloride combined with sufentanil for postoperative epidural analgesia on maternal lactation. Methods A total of 82 women single fetal and term pregnancy planning to undergo cesarean section were divided into two groups. All pregnant women were given continuous epidural anesthesia. Control group （n=40）received intram- uscular injection of pethidine based on postoperative pain. Observation group （n=42）was given 0.125% ropivacaine hydrochloride and 0.5 p~g＂ mL-1 sufentanil for epidural patient-controlled analgesia. Results The observation group had earlier colostrum time and higher number of daily lactation than control group （P〈0.05）. The levels of prolactin in observation group increased after childbirth and were higher than those in control group（P〈0.05）. Conclusion Ropivacaine hydrochloride combined with sufentanil for epidural patient-controlled analgesia can significantly reduce pain-induced decline in lactation and have beneficial effects on maternal rehabilitation and newborn breastfeeding