Kutlucan Leyla, Seker İlknur S, Demiraran Yavuz, Ersoy Özlem, Karagöz İbrahim, Sezen Gülbin, Köse Seyit Ali
Department of Anesthesiology, Düzce University Faculty of Medicine, Düzce, Turkey.
Department of Obstetrics and Gynecology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey.
J Turk Ger Gynecol Assoc. 2014 Dec 1;15(4):233-8. doi: 10.5152/jtgga.2014.14111. eCollection 2014.
Many factors can influence the secretion of breast milk. Cesarean section is a risk factor for late onset of breastfeeding.
In our study, we compared the lactation process by mothers who underwent elective cesarean section under general anesthesia, spinal anesthesia, epidural anesthesia, and normal birth; 84 patients between 18-40 years of age with a risk of ASA I-II were included. Randomly patients were divided into four groups: group G (general anesthesia, n:21), group S (spinal anesthesia, n:21), group E (epidural anesthesia, n:21), and group V (vaginal birth, without anesthesia, n:21). Oxytocin and prolactin values of all patients before and after operation or birth were recorded. In addition the initiation time of lactation after delivery or cesarean section were recorded.
In all groups, there were no significant differences among hormone levels in the prepartum period (p=0.350). Prolactin levels in group G (p=0.011) and oxytocin levels in group V (p=0.012) in the postpartum period were significantly higher than in the other groups. The start of lactation was significantly delayed in group G (p=0.003).
We consider that the onset time of lactation is delayed in patients undergoing cesarean section with general anesthesia when compared with patients who undergo cesarean section with spinal and epidural anesthesia and with patients who undergo normal vaginal birth. Because of the delay of awakening and recovery of cognitive functions in general anesthesia, communication between the mother and the newborn is delayed and so is the lactation.
许多因素会影响母乳分泌。剖宫产是母乳喂养延迟开始的一个风险因素。
在我们的研究中,我们比较了在全身麻醉、脊髓麻醉、硬膜外麻醉下接受择期剖宫产的母亲以及顺产母亲的泌乳过程;纳入了84例年龄在18 - 40岁、ASA I - II级风险的患者。患者被随机分为四组:G组(全身麻醉,n = 21)、S组(脊髓麻醉,n = 21)、E组(硬膜外麻醉,n = 21)和V组(顺产,未麻醉,n = 21)。记录所有患者手术或分娩前后的催产素和催乳素值。此外,记录分娩或剖宫产后泌乳开始的时间。
在所有组中,产前激素水平之间无显著差异(p = 0.350)。产后G组的催乳素水平(p = 0.011)和V组的催产素水平(p = 0.012)显著高于其他组。G组泌乳开始明显延迟(p = 0.003)。
我们认为,与接受脊髓麻醉和硬膜外麻醉的剖宫产患者以及顺产患者相比,全身麻醉下接受剖宫产的患者泌乳开始时间延迟。由于全身麻醉下苏醒和认知功能恢复延迟,母亲与新生儿之间的交流延迟,泌乳也延迟。