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| 罗哌卡因复合舒芬太尼用于不同分娩镇痛方式的半数有效初始容量 |
| Median effective initial volume of ropivacaine combined with sufentanil for labor analgesia using different techniques |
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| DOI：10.12089/jca.2025.08.009 |
| 中文关键词: 罗哌卡因 舒芬太尼 硬膜外镇痛 产科镇痛 |
| 英文关键词: Ropivacaine Sufentanil Epidural analgesia Obstetrical analgesia |
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| 中文摘要: |
目的： 测定并比较0.08%罗哌卡因复合舒芬太尼0.3 μg/ml用于硬膜外阻滞（EA）与硬脊膜穿破硬膜外阻滞（DPE）两种分娩镇痛方式的半数有效初始容量(EIV50)。
方法：选择行分娩镇痛的足月、头位、单胎、初次妊娠产妇51例，年龄20～36岁，BMI 21～35 kg/m2，ASA Ⅱ级，宫颈扩张≤3 cm。采用随机数字表法分为两组：EA组（n=21）和DPE组（n=30）。采用Dixon序贯法，EA组和DPE组首例初始容量分别为18 ml和14 ml，若给药20 min内NRS疼痛评分≤3分，下一例初始容量减少2 ml，反之则增加2 ml。采用Isotonic回归计算EIV50、95%有效初始容量（EIV95）及其95%可信区间（CI）。
结果：EA组和DPE组初始EIV50分别为16.21 ml（95%CI 13.84～17.74 ml）和11.53 ml（95%CI 10.57～14.38 ml），EIV95分别为19.50 ml（95%CI 18.80～22.19 ml）和15.45 ml（95%CI 14.80～18.31 ml），DPE组EIV50和EIV95明显低于EA组（P＜0.05）。
结论：0.08%罗哌卡因复合舒芬太尼0.3 μg/ml用于EA与DPE两种分娩镇痛方式的EIV50分别为16.21 ml（95%CI 13.84～17.74 ml）和11.53 ml（95%CI 10.57～14.38 ml）。DPE用于分娩镇痛时的EIV50比EA减少了29%。 |
| 英文摘要: |
Objective: To determine and compare the median effective initial volume (EIV50) of 0.08% ropivacaine combined with sufentanil 0.3 μg/ml for epidural analgesia (EA) and dural puncture epidural (DPE) in labor.
Methods: Fifty-one full-term, primiparous pregnant women with cephalic presentation and singleton pregnancy, aged 20-36 years, BMI 21-35 kg/m2, ASA physical status Ⅱ, and cervical dilation ≤ 3 cm, who scheduled for labor analgesia were enrolled. They were divided into two groups using a random number table method: group EA (n = 21) and group DPE (n = 30). The Dixon's sequential method was used. The initial volume in the first parturient was 18 ml for group EA and 14 ml for group DPE. If the NRS pain score ≤ 3 within 20 minutes after administration, the initial volume was decreased by 2 ml in the next parturient, otherwise the initial volume was increased by 2 ml in the next parturient. The EIV50, the 95% effective initial volume (EIV95) and 95% confidence interval (CI) were calculated by isotonic regression analysis.
Results: The EIV50 of initial volume was 16.21 ml (95% CI 13.84-17.74 ml) in group EA and 11.53 ml (95% CI 10.57-14.38 ml) in group DPE. The EIV95 of initial volume was 19.50 ml (95% CI 18.80-22.19 ml) in group EA and 15.45 ml (95% CI 14.80-18.31 ml) in group DPE. Compared with group EA, the EIV50 and EIV95 in group DPE were both significantly reduced (P < 0.05).
Conclusion: The EIV50 of 0.08% ropivacaine combined with 0.3 μg/ml sufentanil were 16.21 ml (95% CI 13.84-17.74 ml) for EA and 11.53 ml (95% CI 10.57-14.38 ml) for DPE analgesia. The EIV50 of DPE for labor pain relief was 29% less than that of EA. |
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