Effects Of Sufentanil Postoperative Analgesia On Lactation And Neonatus After Caesarean Section

Objective: Breast milk is the newborn natural food, providing comprehensive neonatal nutrition. Influence of postpartum lactation by many factors, such as maternal health factors, obstetric factors, psychological factors, health education factors, lack of lactation of family history. In recent years, latest type cesarean section, with its fast, high security, to replace a number of difficult vaginal delivery, more and more pregnant women end of the delivery in that way, increasing cesarean section rate every year . Cesarean section pain caused by sympathetic tone, increased catecholamine secretion, increased lactation hormone inhibitive factor of hypothalamus , which inhibit the secretion of prolactin,delayed colostrum and breast-feeding time. Effective postoperative analgesia can inhibit the sympathetic tone to promote prolactin secretion, increased serum prolactin levels. At the same time analgesia can also reduce anxiety,thus increased the cortisol and epidermal growth factor in the milk , also promoting neonatal gastrointestinal function, creating beneficial cycle of breastfeeding is beneficial to health of the newborn and maternal postoperative recovery.Patient-controlled analgesia is commonly used in clinical analgesia after cesarean section. By PCA, the patient's pain experience according to their own pain medication given to the use of individual drugs to smaller doses of drugs to achieve good analgesia, to avoid side effects. Has been widely used in clinical.For a long time, opioids play an important role in the patient-controlled analgesia, along with new types of opioid sufentanil unique pharmacological and pharmacokinetic characteristics of the in-depth understanding of clinical PCA launched a new field of research and application boom.This study, by sufentanil on postoperative analgesia to cesarean section, observed on maternal lactation and newborn, to further explore the feasibility and security on cesarean section and neonate by sufentanil postoperative analgesia ,to provide reference for the choice of analgesic narcotic drug for cesarean section patients . Purpose: To make use of sufentanil on intravenous and epidural analgesia for cesarean section patients, compared to maternal lactation and neonatal effects , to provide reference for the choice of analgesic narcotic drug for cesarean section patients .Method: Select ASAⅠ~Ⅱgrade, elective combined spinal epidural anesthesia (CSEA) 60 cases of cesarean section ,f maternal age 21 to 35 years old, weighing 52 ~ 83kg, 37 to 42 weeks gestational age, term, single child, were randomly divided into three groups, epidural analgesia group (E group), intravenous analgesia group (I group) and intramuscular analgesia group (M group), 20 cases each. VAS score to assess the analgesic effect. Record time of postpartum colostrum, breastfeeding frequency, observation of postoperative nausea and vomiting side effects . And at a specific time by radioimmunoassay plasma prolactin (PRL).At the same time after feeding on neonatal behavioral neurological assessment (NBNA score).Results: 1. VAS score: VAS score after M group was significantly greater than the E group and I group (P﹤0.05), while the E, I was no significant difference between the groups. 2. Postpartum colostrum time, breastfeeding frequency and incidence of side effects:①E, I group the time of colostrum was significantly earlier than M (P﹤0.05); 24h breast-feeding was more than the number of M group.②I group nausea and vomiting were significantly higher than the E, M group (P﹤0.05). 3. PRL changes: postoperative E, I group was significantly higher than preoperative PRL and M group (P﹤0.05), while the E, I was no significant difference between the groups. 4. Newborns NBNA score: three groups at each time point were more than 35 points.No significant difference between groups.Conclusions: The results show that, through good postoperative analgesia can improve maternal lactation and improve the success rate of breastfeeding. And sufentanil for epidural and intravenous analgesia reliable, less adverse reactions, used in analgesia after cesarean section can significantly improve maternal lactation, and no adverse effects on the newborn.