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Anesthesiology:产科硬膜外麻醉---芬太尼剂量和母乳喂养成功的关系:随机临床实验

2017-11-13 于晓旭 罂粟花

母乳喂养是一个重要的公众关心的问题。据报道,用于分娩镇痛的硬膜外芬太尼总剂量与母乳喂养的提前终止有关。我们检测了一种假设,即用于分娩时硬膜外麻醉使用的芬太尼剂量会对母乳喂养的成功不利。

背景与目的:母乳喂养是一个重要的公众关心的问题。据报道,用于分娩镇痛的硬膜外芬太尼总剂量与母乳喂养的提前终止有关。我们检测了一种假设,即用于分娩时硬膜外麻醉使用的芬太尼剂量会对母乳喂养的成功不利。

方  法:本研究为随机、双盲、对照试验,选择妊娠期大于38周且计划进行母乳喂养的经产妇,已经成功地母乳喂养过一个婴儿,并接受神经分娩镇痛。受试者随机接受三种硬膜外麻醉(布比卡因1mg/ml,布比卡因0.8mg/ml与芬太尼1μg/ml协同使用,或布比卡因0.625mg/ml与芬太尼 2 μg/ml协同使用)。主要指标为产后6周产妇母乳喂养比例。并测试分娩时母体和脐静脉血芬太尼和布比卡因的浓度。

结  果:共有345名女性参与随机分组,305名女性有完整数据可供分析。6周时额分别接受硬膜外芬太尼0、1和2 μg/ml麻醉的母乳喂养比例为97%、98%和94% (P=0.34)。芬太尼总剂量差异:37μg[差异的95%置信区间,-58到79 μg,P=0.28],停止母乳喂养的妇女和在产后6周仍在哺乳的妇女母体和脐带静脉血中芬太尼和布比卡因浓度没有差异。

结  论:分娩时使用2μg/ml芬太尼的硬膜外麻醉不会影响产后6周的母乳喂养率。

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    2018-01-14 heli0118
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    2017-11-15 villahu
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    2017-11-15 xue8602
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    2017-11-15 skhzy
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    2017-11-13 1e0f8808m18(暂无匿称)

    学习了.好文章.

    0

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