INFLUENCE OF EPIDURAL PATIENT-CONTROLLED ANALGESIA ON PLASMA CONCEN-TRATION OF PROLACTIN IN PARTURIENT AFTER CESAREAN SECTION

Objective :To observe the effects of epidural patient-controlled analgesia( PCEA) with fenta-nyl and bupivacaine on plasma prolactin level after cesarean section. Methods: Ninty maturus primiparous women participated in the study, sixty parturients having undergone elective cesarean section under epidural anesthesia and thirty having natural palturition. The sixty parturients undergone elective cesarean section were randomly and evenly allocated to PCEA group (group Ⅰ) and control group (group Ⅱ). The thirty parturients having natural parturition served as group Ⅲ. In PCEA group received epidural fentanyl and bupivacaine, and in control group without postoperative analgesia. The plasma prolactin levels were determined with radioimmunossay. The analgesic efficacy was evaluated with visual analog scale ( VAS). Results; In PCEA group the VAS score was significantly lower and the colostrum secretion was significantly earlier than those in control group ( P 0. 01 or P0.05). The plasma prolactin of the three groups increased markedly 24h and 48 h after cesarean section or parturition compared with those before surgery or parturition( P 0. 01 ). The plasma prolactin level was obviously higher in PCEA group 24h and 48h after cesarean section than control group. In PCEA group, parturients slept well after surgery, MAP HR were kept stable during the whole procedures without respiratory depression and vomiting. Conclusion : Epidural patient-controlled analgesia with fentanyl and bupivacaine is not only safe and effective for postoperative analgesia after cesarean section , but also increase the prolactin secreation to improve maternal colostrum.