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目的:通过序贯法测定舒芬太尼鞘内注射用于分娩镇痛的最小有效剂量。方法:选择要求分娩镇痛、ASAI～Ⅱ级、单胎、头位、足月妊娠的初产妇29例,产前无服用镇痛催眠药史。根据序贯法,按等比1.2倍的阶梯增减给药,以上一例产妇的镇痛效果确定下一例产妇所用舒芬太尼的剂量,初始舒芬太尼剂量为3.5μg。序贯给药后记录相应的观察指标,镇痛效果以视觉模拟评分法(VAS)进行评估,VAS≤3分为有效。按Dixon and Massey序贯分配试验法公式,计算舒芬太尼ED50及95%可信区间。结果:舒芬太尼鞘内注射分娩镇痛的ED50值是2.3μg,95%可信区间为1.7～2.9μg。结论:序贯增减法简便、高效、结果可信,适于测定舒芬太尼鞘内注射用于分娩镇痛的最小有效剂量。
OBJECTIVE: To determine the minimum effective dose of sufentanil intrathecal injection for labor analgesia by sequential method. Methods: 29 primiparae women who required labor analgesia, ASAI ~ Ⅱ grade, singleton, head position and full term pregnancy were enrolled in the study. According to the sequential method, according to the same ratio of 1.2 times the step increase or decrease administration, the analgesic effect of the above one maternal to determine the next case of sufentanil dose, the initial dose of sufentanil is 3.5μg. After sequential administration, the corresponding observation indexes were recorded. The analgesic effect was evaluated by visual analogue scale (VAS). VAS≤3 was divided into effective. According to Dixon and Massey sequential distribution test formula, calculate sufentanil ED50 and 95% confidence interval. Results: The ED 50 value of sufentanil for intrathecal labor analgesia was 2.3 μg and the 95% confidence interval was 1.7-2.9 μg. Conclusion: Sequential increase and decrease method is simple, efficient and reliable. It is suitable for the determination of the minimum effective dose of sufentanil used for labor analgesia.