剖宫产术后应用罗哌卡因联合舒芬太尼硬膜外镇痛对产妇泌乳的影响  

Influence of ropivacaine in combined with sufentanil epidural analgesia on maternal lactation after undergoing cesarean section

作　　者：冯琥[1] 陈宝霞[1] 任熙[1] 朱红霞[1] 

机构地区：[1]河北北方学院附属第二医院

出　　处：《海南医学院学报》2016年第11期1109-1111,共3页Journal of Hainan Medical University

基　　金：张家口市科学技术研究与发展指导计划项目(1321109D)~~

摘　　要：目的：观察剖宫产术后采用罗哌卡因联合舒芬太尼硬膜外镇痛对产妇泌乳及新生儿的影响。方法：对我院剖宫产术后采用不同镇痛方式的产妇进行观察,入选产妇均在脊椎硬膜外联合麻醉（CSEA）下完成剖宫产术,将术后采用罗哌卡因联合舒芬太尼硬膜外镇痛产妇30例设为观察组,术后采用哌替啶间断肌肉注射镇痛的产妇30例设对照组,观察两组产妇术后镇痛效果,采用放射免疫法检测血浆泌乳素（PRL）水平,并对比两组产妇产后初乳时间、24h哺乳次数及新生儿哺乳后的神经行为评分（NBNA）。结果：观察组术后疼痛VAS评分明显低于对照组（P〈0.05）,血浆PRL水平明显高于对照组（P〈0.05）;观察组术后初乳时间明显早于对照组（P〈0.05）,哺乳次数明显多于对照组（P〈0.05）。结论：剖宫术后采用罗哌卡因联合舒芬太尼硬膜外镇痛能有效缓解产妇术后疼痛,改善产妇泌乳,且对新生儿无不良影响,效果可靠。Objective：To observe the influence of ropivacaine in combined with sufentanil epidural analgesia on maternal lactation after undergoing cesarean section Methods：A total of 60 puerpera who underwent cesarean section under combined spinal epidural anesthesia（CSEA）were selected,30 of which were given ropivacaine in combined with sufentanil epidural analgesia after the operation served as observation group,while 30 cases who were intermittently given intramuscular injection of pethidine after the operation served as control group.The postpartum analgesic effects in the two groups were observed and compared.The radioimmunoassay was used to detect the plasma PRL level.The postpartum colostrum time,24 hlactation number,and NBNA scores in the two groups were compared.Results：The postoperative VAS score in the observation group was significantly lower than that in the control group（P〈0.05）,while the plasma PRL level was significantly higher than that in the control group（P〈0.05）.The postoperative colostrum time in the observation group was significantly earlier than that in the control group（P〈0.05）,while lactation was significantly more frequent than that in the control group（P〈0.05）.Conclusions：Ropivacaine in combined with sufentanil epidural analgesia after cesarean section can effectively alleviate the postoperative pain,and improve the lactation without inducing obvious adverse reactions on the neonates.

关 键 词：舒芬太尼 剖宫产术 产后镇痛 VAS 泌乳 

分 类 号：R719.8[医药卫生—妇产科学]