|本期目录/Table of Contents|

[1]杨 蕾,于泳浩.改良序贯法测定蛛网膜下腔注射舒芬太尼用于分娩镇痛中的半数有效剂量[J].天津医科大学学报,2019,25(03):264-266,270.
　YANG Lei,YU Yong-hao.Modified sequential method for the determination of 50% effective dose of sufentanil for intrathecal injection in labor analgesia[J].Journal of Tianjin Medical University,2019,25(03):264-266,270.
点击复制

改良序贯法测定蛛网膜下腔注射舒芬太尼用于分娩镇痛中的半数有效剂量(PDF)
分享到：

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
25卷
期数:
2019年03期
页码:
264-266,270
栏目:
临床医学
出版日期:
2019-05-20

文章信息/Info

Title:
Modified sequential method for the determination of 50% effective dose of sufentanil for intrathecal injection in labor analgesia
文章编号:
1006-8147(2019)03-0264-04
作者:
杨 蕾1; 于泳浩2
（1.天津医科大学研究生院，天津300070；2.天津医科大学总医院麻醉科，天津300052）
Author(s):
YANG Lei1;  YU Yong-hao2
（1. Graduate School, Tianjin Medical University, Tianjin 300070, China; 2. Department of Anesthesiology, General Hospital, Tianjin Medical University, Tianjin 300052, China)
关键词:
舒芬太尼; 蛛网膜下腔注射; 分娩镇痛; 序贯法; 半数有效剂量
Keywords:
sufentanil;  intrathecal injection;  labor analgesia;  sequential method;  half effective dose
分类号:
R614
DOI:
-
文献标志码:
A
摘要:
目的：采用改良序贯法测定蛛网膜下腔单纯注射舒芬太尼用于分娩镇痛中的半数有效剂量（ED50）。方法：选择足月妊娠、单胎、头位且自愿接受分娩镇痛的初产妇30例，美国麻醉医师协会（ASA）分级I～Ⅱ级，于腰-硬联合神经阻滞下接受分娩镇痛。根据改良序贯法增减给药，第1例产妇蛛网膜下腔单纯注射舒芬太尼5.0 μg，相邻剂量梯度为0.5 μg，若上1例产妇镇痛效果满意，则下1例产妇剂量减少0.5 μg；若上1例产妇镇痛效果不满意，则下1例产妇剂量增加0.5 μg。序贯给药后采用视觉模拟评分法（VAS）评估镇痛效果，VAS≤3分为镇痛有效。采用Dixon and Massey序贯分配试验法公式计算舒芬太尼蛛网膜下腔注射用于分娩镇痛中的ED50和95%可信区间。结果：蛛网膜下腔单纯注射舒芬太尼用于分娩镇痛中的ED50为2.85 μg，95%可信区间为2.31～3.43 μg。结论：采用改良序贯法测得的蛛网膜下腔单纯注射舒芬太尼用于分娩镇痛中的ED50为2.85 μg，且此法简便、高效、准确性高。
Abstract:
Objective: To determine the half effective dose （ED50） of intrathecal sufentanil for labor analgesia by modified sequential method. Methods: Thirty primiparas with term pregnancy, singleton, head position and voluntary labor analgesia were selected according to The American Society of Anesthesiologists(ASA) graded I to II, and subjects received labor analgesia under combined spinal epidural anesthesia. According to the modified sequential method, the first dose of sufentanil was 5.0 μg, and the adjacent dose gradient was 0.5 μg. If the previous analgesia was effective, the next dose would be reduced by 0.5 μg. If the previous analgesia is not effective, the next dose of maternal dose would be increased by 0.5 μg. After sequential administration, visual analgesia(VAS) was used to evaluate the analgesic effect. VAS≤3 was effective in analgesia. The ED50 and 95% confidence intervals for intrathecal sufentanil for labor analgesia were calculated using the Dixon and Massey sequential distribution test formula. Results: The intrathecal injection of sufentanil for labor analgesia showed an ED50 of 2.85 μg and a 95% confidence interval of 2.31 to 3.43 μg. Conclusion: The ED50 of intrathecal sufentanil for labor analgesia measured by modified sequential method is 2.85 μg, and the method is simple, efficient and accurate.

参考文献/References:

[1] Li B, Wang H, Gao C. Bupivacaine in combination with fentanyl or sufentanil in epidural/intrathecal analgesia for labor: a meta-analysis [J]. J Clin Pharmacol, 2015, 55(5): 584
[2] Tian F, Wang K, Hu J, et al. Continuous spinal anesthesia with sufentanil in labor analgesia can induce maternal febrile responses in puerperas [J]. Int J Clin Exp Med, 2013, 6(5): 334
[3] 蒋焕伟, 徐世元, 方曼菁, 等.硬膜外罗哌卡因复合舒芬太尼或芬太尼用于潜伏期分娩镇痛[J].临床麻醉学杂志, 2015, 31(3): 221
[4] Roelants F, Lavand’homme P. Clonidine versus sufentanil as an adjuvant to ropivacaine in patient-controlled epidural labour analgesia: A randomised double-blind trial[J]. Eur J Anaesthesiol, 2015, 32(11):805
[5] Zhang Y F, Xiao F, Xu W P, et al. Prophylactic infusion of phenylephrine increases the median effective dose of intrathecal hyperbaric bupivacaine in cesarean section: A prospective randomized study [J]. Medicine (Baltimore), 2018, 97(32): e11833
[6] 全伟斌.腰硬联合阻滞分娩镇痛的临床应用进展[J].医学综述,2013, 19(8): 1475
[7] 徐文平,刘林,肖飞,等.罗哌卡因联合舒芬太尼硬膜外麻醉对可行走无痛分娩阵镇痛的效果研究[J].中国生化药物杂志, 2017,(4):320
[8] 韩玲,张东升,包金莲.蛛网膜下腔注射不同剂量舒芬太尼在分娩镇痛中的应用价值 [J]. 医学临床研究, 2016,12: 2407
[9] Herman N L, Calicot R, Van Decar T K, et al. Determination of a dose response relationship for intrathecal sufentanil in laboring patients[J]. Anesth Analg,1997, 84(6): 1256
[10] 魏威.蛛网膜下腔给予不同剂量舒芬太尼进行分娩镇痛的效果比较[J].临床和实验医学杂志,2017, 16(6): 613
[11] 熊振辉,马建军.分娩镇痛蛛网膜下腔注射舒芬太尼最佳剂量的临床观察[J].浙江临床医学, 2013(7): 1069
[12] 李煜, 张永福, 赖国忠, 等.序贯法测定舒芬太尼蛛网膜下腔注射用于分娩镇痛的最小有效剂量[J].中国妇幼保健, 2012, 27(5):768

相似文献/References:

备注/Memo

备注/Memo:
作者简介 杨蕾（1987-）,女，主治医师，硕士在读，研究方向：妇产科麻醉；通信作者：于泳浩，E-mail: yuyonghao@126.com。
更新日期/Last Update: 2019-07-03