Hirose M, Hara Y, Hosokawa T, Tanaka Y
Department of Anesthesiology, Kyoto Prefectural University of Medicine, Japan.
Anesth Analg. 1996 Jun;82(6):1166-9. doi: 10.1097/00000539-199606000-00011.
The purpose of this study is to determine the effect of postoperative analgesia on the amount of breast feeding and infant weight gain. Thirty parturients undergoing elective cesarean section under spinal anesthesia were randomly allocated to receive postoperative pain management with (S-E group, n = 15) or without epidural bupivacaine (S group, n = 15). Epidural analgesia was performed for 3 days with a continuous epidural infusion (0.7 mL/h) of 0.25% bupivacaine. Diclofenac was available on demand in all patients. The weight of milk fed by breast and the infant weight were measured for 11 days after cesarean section. In the S-E group, the visual analog pain score after surgery was significantly lower and both the weight of milk fed by breast and the infant weight during the study were significantly more than the respective values in the S group. The S group required a larger dose of diclofenac after the operation than did the S-E group. We suggest that satisfactory postoperative pain relief with continuous epidural bupivacaine for 3 days after cesarean section improved the amount of breast feeding and the gain of infant weight.
本研究的目的是确定术后镇痛对母乳喂养量和婴儿体重增加的影响。30例在脊麻下行择期剖宫产的产妇被随机分配,分别接受含(S-E组,n = 15)或不含硬膜外布比卡因的术后疼痛管理(S组,n = 15)。采用持续硬膜外输注(0.7 mL/h)0.25%布比卡因进行硬膜外镇痛3天。所有患者均可按需使用双氯芬酸。剖宫产术后11天测量母乳喂养的奶量和婴儿体重。在S-E组,术后视觉模拟疼痛评分显著更低,且研究期间母乳喂养的奶量和婴儿体重均显著高于S组的相应值。S组术后所需双氯芬酸的剂量比S-E组更大。我们认为,剖宫产术后连续3天使用硬膜外布比卡因实现满意的术后疼痛缓解,可改善母乳喂养量和婴儿体重增加情况。