| Objective: The effects of different anesthesia on early lactation function were compared.Methods:150 single-term full-term maternal women,aged 20~35 years old,height150 ~ 170 cm,weight 50 ~ 90 kg,ASA I or II,divided into five groups according to different anesthesia methods(n = 30),group G underwent general anesthesia for cesarean section,the group S underwent combined spinal and epidural anesthesia for cesarean section,the group E underwent epidural anesthesia for cesarean section,the group P for painless delivery,and the group V for natural delivery as a control.The postpartum colostrum time,the number of effective lactation at 24 h,the total postpartum hospital stay,satisfaction,adverse reactions,postoperative 12 h,24h,36 h VAS analgesic score and neonatal 1 and 5 min Apgar scores were recorded.Results:1.The colostrum time of the V group was the earliest in the five groups of primipara,but there was no significant difference between the V group and the P group(P>0.05).The colostrum time in group V and group P was significantly earlier than that in group G,group S and group E(P<0.05).The colostrum time in group G was significantly earlier than that in group S and group E during cesarean section(P<0.05).The colostrum time in group E was the latest,but there was no significant difference in colostrum time between group E and group S(P>0.05).2.The total time of postpartum hospitalization was the shortest among the five groups of primiparas,but there was no significant difference in the total postoperative hospitalization time between group V and group P(P>0.05).The total postpartum hospitalization time in group V and group P was significantly shorter than that in group G,group S and group E(P<0.05).The total time of postpartum hospitalization in group G was the longest in cesarean section,which was significantly longer than that in group S and group E(P<0.05).3.The highest lactation rate in group V was 24(80%),which was significantly higher than that in other groups(P<0.05).23(76.7%)patients in group P and 24(80%)patients in group V were significantly higher than 11(36.7%)patients in group G of cesarean section,20(66.7%)patients in group S,and 15(50%)patients in group E.(P<0.05).In the anesthesia cesarean section,20(66.7%)patients in the S group were significantly higher than 11(36.7%)patients in the G group and 15(50%)patients in theE group(P<0.05).4.The VAS score was the highest in the G group at 12 hours after surgery,but there was no significant difference between the G group and the V group(P>0.05).The G group and the V group were significantly higher than the S group,the E group and the P group(P<0.05).There were no significant differences in VAS scores between the 24 hours postoperative groups(P>0.05).The VAS scores at 36 hours after surgery were significantly higher in G group,S group and E group than in P group and V group(P<0.05).5.The incidence of adverse reactions in the five groups of primiparas was E group33.3%(10 cases),G group 26.7%(8 cases),S group 16.7%(5 cases),P group 16.7%(5cases),V group 0%(0 cases).Adverse reactions mainly manifested as nausea,dizziness,vomiting,itchy skin,numbness of the lower limbs,chills and so on.6.There were no significant differences in the satisfaction of the five groups of primipara and the 1 and 5 min Apgar scores(P>0.05).Conclusion:1.Different anesthesia methods have certain influence on early postpartum lactation,but no significant difference in lactation function between painless and natural delivery.2.Different anesthesia methods for cesarean section have a certain delay in postpartum lactation,but the combined adverse effects of combined spinal and epidural anesthesia on postpartum colostrum time,24 h effective lactation and adverse reactions are less than general anesthesia and epidural anesthesia.In order to promote lactation after cesarean section,the combination of lumbar and spinal anesthesia is preferred;general anesthesia is selected for those who have contraindications for spinal anesthesia. |
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