摘要
目的探讨罗哌卡因用于足月产妇阴道分娩镇痛对催乳素（PRL）水平、泌乳始动时间及泌乳量充足率的影响。方法选择北京市海淀区妇幼保健院产科2006年1月至2007年6月足月阴道分娩产妇124例，随机分为分娩镇痛组75例，对照组49例。分娩镇痛组产妇应用硬膜外电子镇痛泵持续泵入罗哌卡因用于分娩镇痛，先以0．125％罗哌卡因3ml注入硬膜外腔，观察5min无异常反应后再注入12ml，将麻醉平面控制在胸10以下，以5ml／h（0．104mg／min）的速度持续泵入罗哌卡因，直至宫口开全后关闭镇痛泵。对照组为自然分娩产妇，不用任何镇痛措施。应用微粒子化学发光法分别测定两组产妇产前、产后0、2、6、12和24h血清催乳素水平，记录泌乳始动时间和每日新生儿哺乳次数，并以新生儿排尿次数和哺乳后睡眠时间判断泌乳量充足与否，测量产后24h的新生儿体重下降情况。结果（1）两组产妇催乳素水平产后即开始升高，于产后2h达到高峰，并于产后24h维持在较高水平上。（2）分娩镇痛组产妇催乳素水平在产后2、24h分别为（19．5±8．4）、（14．5±5．6）nmol／L，对照组产妇催乳素水平在产后2、24h分别为（22．6±7．2）、（16．9±5．7）nmol／L，两组分别比较，差异均有统计学意义（P〈0．05）。（3）分娩镇痛组产妇泌乳始动时间在产后24h内者为73例（97％，73／75），泌乳量充足率在产后48h内为73％（55／75），产后24h新生儿体重下降（57±42）g；对照组产妇泌乳始动时间在产后24h内为45例（92％，45／49），泌乳量充足率在产后48h为57％（28／49），产后24h新生儿体重下降（62±40）g，两组分别比较，差异均无统计学意义（P〉0．05）。结论（1）罗哌卡因用于分娩镇痛可影响产妇的催乳素分泌，但不影响泌乳始动时间和泌乳量充足率。（2）罗哌卡因用于分娩镇痛时，产
Objective To examine the effect of labor analgesia with ropivacaine on maternal serum prolactin, time of first colostrum production and the rate of abundant lactation. Methods A total of 124 women of vaginal delivery were randomly divided into labor analgesia group （ n = 75） and control group （n =49 ）. Labor analgesia group received ropivacaine by patient-controlled epidural analgesia. Three ml ropivacaine （0. 125% ） was injected through an epidural catheter and another 12 ml ropivacaine was injected 5 min later if there were no total spinal anesthesia. The block level of analgesia was controlled to be below T10 level. Then 5 ml （0. 104 mg/min） ropivacaine per hour was continuously pumped till full dilation of ostium of the uterus. The control group consisted of women of normal spontaneous delivery with no pain relieving measure. The prolactin levels of antepartum, postpartum 0 h, 2 h, 6 h, 12 h and 24 h were determined by microparticle chemoluminescence. Starting time of lactation, the feeding times in 24 hours, the rate of abundant lactation, and neonatal weight 24 hours after delivery were recorded. Results （ 1 ） The serum prolactin of both groups increased instantly after delivery, reached a peak 2 hours after delivery and kept high levels 24 hours after delivery. （2） The prolactin levels of labor analgesia group [ （ 19. 5 ± 8.4 ） nmol/L and （14. 5 ± 5.6） nmol/L] were lower than those of control group [ （22. 6 ± 7.2） nmol/L and （ 16.9 ± 5.7 ） nmol/L] 2 and 24 hours after delivery （ P 〈 0. 05 ）. （ 3 ） In labor analgesia group the starting time of lactation was within 24 hours after delivery in 73 cases （97%）, lactation amount was abundant within 48 hours in 55 cases （73%） and newborn weight reduction in the first day after delivery was（57 ± 42）g. In control group the starting time of lactation was within 24 hours after delivery in 45 cases （92%）, lactation amount was abundant within 48 hours in 28 cases （ 57% ） and newborn weight reduct
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2008年第7期502-505,共4页
Chinese Journal of Obstetrics and Gynecology
关键词
镇痛
产科
酰胺类
催乳素
泌乳
Analgesia, obstetrical
Amides
Prolactin
Lactation
