The Influence Of Postoperative Patient Controlled Epidural Analgesia On Lactation And The Correlated Factors After Cesarean Section

Objective: To observe the influence of PCEA on lactation and the correlated factors after cesarean section.Methods: Thirty full-term parturients who have no other complications such as diabetes , cardiopathy , thyroid gland disease .undergoing elective cesarean section under epidural anaesthesia randomly divided into two groups: the PCEA group(n=15)and the controlled group(n=15).All the women were volunteered .All the women were choosed epidural anaesthesia 1.5% lidocaine. The dose of lidocaine and the operation time were no significant difference. The PCEA group: epidural anesthesia followed by postoperative patient-controlled analgesia(PCEA)with epidural morphine, fentanyl and bupivacain.We set the basal injection rate was 2ml / h, the locked time was 30minutes and the controlled injection dose was 5ml each time. The controlled group wasn't injected any analgesia agent. Assessed the degree of the pain by using visual analog scale(VAS).Detect the prolactin(PRL) and thyroid stimulating hormone(TSH) level in plasma before operation, after operation 24h,48h separately by electrochemiluminescence immunoassay(ECLI). And compare the difference of the two groups. Keep note of the first time that puerperal women had milk and the times that breastfeeding their infants everyday and whether supplied the supplements of milk or not. All the data were analyzed statistically.Results :The VAS scores of the PCEA group were lower than that of the controlled group(p<0.01). The first lactation time of the PCEA group was distinctively earlier than that of the controlled group (p<0.01). Breastfeeding their infants more than 8 times every 24 hour, the PCEA group was significantly more than the controlled group(p<0.01). The amount of the milk during 72 hours , the PCEA group was higher than the controlled group(p<0.01). The postoperative level of PRL , TSH in plasma of PCEA group were all higher than that of before operation(p<0.05). The postoperative 24h, 48h PRL, TSH concentration in plasma of the PCEA group were higher than the controlled group(p<0.05). .Nursing times of the PCEA group were distinctive higher than the controlled group.Conclusion:The PCEA has a very good effect on puerperal women and can enhance their comfortableness ,make them have a good rest and sleep, so they can contact with their infants as early as they can and as possible as they can, have moreenergy to nurse their infants, advance the first lactation time, and stimulate the secreting of PRL TSH.