Mid Sweden Research & Development Centre, Västernorrland County Council, Sundsvall, Sweden.
J Clin Nurs. 2010 May;19(9-10):1326-34. doi: 10.1111/j.1365-2702.2010.03213.x.
The aim was to evaluate a new anaesthetic routine and to study the effect of spinal opioids for caesarean section on postoperative pain, expectations of pain, satisfaction with pain treatment, breastfeeding, infant care and length of hospital stay.
Inadequate postoperative pain relief is a problem among hospitalised patients. Women undergoing caesarean section have been shown to experience high levels of pain during the first days after operation. Women are expected to breastfeed and care for their newborn while recovering from major abdominal surgery and sufficient pain relief are of importance.
Comparative patient survey.
Data were collected through a questionnaire distributed to two independent samples of women undergoing elective and emergency caesarean section before and after the introduction of an additive of opioids in obstetric spinal anaesthesia. Chi-square tests were performed, and risk ratios were used for bivariate analysis. Logistic regression modelling was used for multivariate analysis.
The group of women undergoing caesarean section with opioids added to the spinal anaesthesia reported significantly lower levels of experienced pain. High pain levels irrespective of mode of caesarean section affected breastfeeding and infant care. Length of hospital stay for caesarean women was shortened and the consumption of analgesics was reduced.
Women receiving an additive of opioids in spinal anaesthesia experienced lower levels of pain. Low pain levels facilitate breastfeeding and infant care and are of relevance for financial considerations.
The results of this study indicate that spinal opioids for women undergoing caesarean section have a positive effect on the postoperative pain experience. Women undergoing caesarean section and have high pain levels are in special need of attention and care because of a higher risk of a decreased ability to breastfeed and to take care of their newborn.
评估一种新的麻醉方案，并研究剖宫产时脊髓内应用阿片类药物对术后疼痛、疼痛预期、疼痛治疗满意度、母乳喂养、婴儿护理和住院时间的影响。
住院患者术后疼痛缓解不足是一个问题。接受剖宫产的女性在手术后的头几天会经历高水平的疼痛。女性在接受腹部大手术后需要恢复，并且需要充分的止痛，以进行母乳喂养和照顾新生儿。
患者对照调查。
通过问卷调查收集数据，该问卷在椎管内麻醉中添加阿片类药物前后分发给两组行择期和急诊剖宫产的女性。采用卡方检验，并用风险比进行双变量分析。采用逻辑回归模型进行多变量分析。
椎管内麻醉中加入阿片类药物的剖宫产女性报告的疼痛水平显著降低。剖宫产方式无关，高疼痛水平会影响母乳喂养和婴儿护理。剖宫产女性的住院时间缩短，镇痛药用量减少。
椎管内麻醉中加入阿片类药物的女性疼痛程度较低。低疼痛水平有利于母乳喂养和婴儿护理，对经济因素也有影响。
本研究结果表明，剖宫产时脊髓内应用阿片类药物对术后疼痛体验有积极影响。疼痛程度较高的剖宫产女性需要特别关注和护理，因为母乳喂养和照顾新生儿的能力下降的风险更高。
