【摘要】 目的观察剖宫产术后经静脉镇痛对宫缩、泌乳及胎儿体重的影响。方法选择 3 0例健康足月无妊娠合并症 ,并发症在硬膜外麻下行剖宫产产妇 ,术后自愿接受静脉镇痛为镇痛组 ,选择同期条件相同未行静脉镇痛的产妇3 0例为对照组。镇痛组在剖宫产术后 ,采用病人自控静脉镇痛 (PCIA)给予芬太尼 ,芬太尼持续剂量 2 0～ 2 5 μg/h ,镇痛时间 48h ,采用放射免疫法测血浆催乳素 (PRL)浓度。结果镇痛组术后第 1天PRL增高 ,显著高于对照组(P <0 .0 5 ) ,镇痛组初乳时间较对照组提前(P <0 .0 5 ) ,两组产后流血、宫缩、肠蠕动恢复时间 ,婴儿体重增减无显著性差异 (P >0 .0 5 ) ,但镇痛组术后出现呕吐的产妇高于对照组 (P <0 .0 1)。结论剖宫产术后采用芬太尼PCIA ,能使初乳时间及PRL分泌提前 ,不影响宫缩 ,对婴儿亦无不良影响更多还原

【Abstract】 ObjectiveTo observe the effects of intravenous analgesia on uterine contraction, colostrum secretion and infant weight after Cesarean section.MethodsSixty parturients were divided into two groups: (1) Intravenous analgesia (IA) group---Cesarean sections were performed under epidural anesthesia in 30 full term parturient who had no pregnancy-concurrent conditions and complications. They volunteered to receive IA after operation; (2) Control group---IA was not given after Cesarean section in other 30 parturients with the same conditions during the same period. In IA group, intravenous fentanyl was administered under self-control at the rate of 20～25 ug/h. Its analgesic action lasted 48 hours. Their plasma concentration of prolactin (PRL) was determined with radioimmunoassay (RIA). ResultsPlasma PRL levels in IA group increased on the first day after Cesarean section, significantly higher than those in control group (P<0.01); whereas their colostrum secretion was earlier than that in control group (P<0.05). No obvious differences in postpartum hemorrhage, uterine contraction, peristalsis resumption time and infant weights were found between two groups (P>0.05), but the incidence of vomiting after Cesarean section in IA group was higher than that in control group (P<0.01). ConclusionIA with fentanyl after Cesarean section makes colostrum and PRL secretion earlier, not affecting uterine contraction and infant weight.更多还原