高乌甲素复合布托啡诺剖宫产术后镇痛效果及对血浆泌乳素的影响

目的探讨氢溴酸高乌甲素复合布托啡诺用于剖宫产术后静脉镇痛的效果及对血浆泌乳素（prolactin,PRL）的影响。方法将50例无合并症和无母乳喂养禁忌证的择期剖宫产术产妇分为观察组（n=25）与对照组（n=25）。观察组使用持续静脉自控镇痛,布托啡诺5 mg＋高乌甲素40 mg＋昂丹司琼8 mg用0.9%生理盐水稀释至75 m l;对照组肌注曲马多。观察两组产妇术后4、8、12、24 h的VAS评分及术后产妇24 h血浆PRL浓度。结果观察组VAS明显低于对照组（P〈0.01）,术后24 h血浆PRL浓度明显高于对照组（P〈0.05）。两组产妇术后24 h血浆PRL浓度明显高于术前水平（P〈0.01）,镇痛期间副作用发生情况无显著差异。结论氢溴酸高乌甲素复合布托啡诺用于剖宫产术后静脉镇痛效果确切,副作用少,对产妇PRL分泌影响小。

Analgesic efficacy of postoperative analgesia with lappaconitine composite b-utorphanol and its influence on prolactin in parturient after cesarean section

Aim To observe the analgesic efficacy of postoperative analgesia with lappaconitine composite butorphanol and its influence on plasma prolactin level after cesarean section.Methods 50 patients without complications and non-breastfeeding contraindication undergoing elective cesarean section were randomly allocated to observer group(n=25)and control group(n=25).Observer group use intravenous patient-controlled analgesia,butorphanol 5 mg+ Lappaconitine 40 mg+ondansetron 8 mg+0.9%NS 75 ml,tramadol was injected IM when postoperative pain appeared in control group.The VAS score after 4,8,12,24 hours and the plasma prolactin level after the 24 hours cesarean section of the two groups were observed.Results In observer group,the VAS score was significantly lower than that in control group(P<0.01).The plasma prolactin level was significantly higher in observer group 24 h after cesarean section than that in control group(P<0.05).The plasma levels of prolactin of both groups increased significantly 24 h after cesarean section compared with those before surgery(P<0.01).The side effect is no difference in two groups during analgesia.Conclusion Intravenous patient-controlled analgesia with lappaconitine composite butorphanol is not only safe and effective for postoperative analgesia after cesarean section,but also increase the plasma prolactin lever.