程控硬膜外间歇脉冲注入在硬脊膜穿破硬膜外分娩镇痛90%有效间隔时间的测定  

Determination of 90% effective interval time of programmed intermittent epidural bolus in dural puncture epidural block for labor analgesia

作　　者：林峰[1] 徐丹兵[1] 曹建斌 项海飞[1] 王明仓[1] LIN Feng;XU Danbing;CAO Jianbin;XIANG Haifei;WANG Mingcang(Department of Anesthesiology,Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,Taizhou 317000,China)

机构地区：[1]浙江省台州医院、台州恩泽医疗中心(集团)恩泽医院麻醉科,317000

出　　处：《浙江医学》2022年第6期625-628,共4页Zhejiang Medical Journal

基　　金：台州市社会发展科技计划项目(20ywb70)。

摘　　要：目的测定程控硬膜外间歇脉冲注入(PIEB)技术在硬脊膜穿破硬膜外分娩镇痛中的90%有效间隔时间(EI90)。方法选取2021年1至7月浙江省台州医院自愿行分娩镇痛的初产妇50例,采用PIEB维持镇痛,用药为0.1%罗哌卡因+0.5μg/ml舒芬太尼,单次脉冲剂量为8 ml。采用有偏硬币设计序贯法,确定间歇脉冲给药的EI90。结果采用截断Dixon-Mood法,EI90为54.0 min(95%CI:39.5~58.5)。采用保序回归分析,EI90为51.5 min(95%CI:46.7~62.5)。使用0.1%罗哌卡因+0.5μg/ml舒芬太尼时,PIEB在硬脊膜穿破硬膜外分娩镇痛的有效间隔时间为52.8 min。结论使用0.1%罗哌卡因+0.5μg/ml舒芬太尼时,PIEB在硬脊膜穿破硬膜外分娩镇痛的EI90为52.8 min。Objective To determine the 90%effective interval time(EI90)of programmed intermittent epidural bolus(PIEB)in dural puncture epidural block for labor analgesia.Methods Fifty primiparas undergoing labor analgesia with dural puncture epidural block in Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University from January to July 2021 were enrolled in the study,the analgesia was maintained by PIEB technique with 0.1% ropivacaine+0.5μg/ml sufentanil(8 ml/time).The EI90 of PIEB administration was determined by biased coin design sequential method.Results Using truncated Dixon and Mood methods,the EI90 was estimated at 54 min(95%CI:39.5-58.5),using a rank-preserving regression analysis,the EI90 was estimated at 51.5 min(95%CI:46.7-62.5),while using 0.1% ropivacaine+0.5μg/ml sufentanil(8 ml/time),the effective PIEB time interval in dural puncture epidural block for labor analgesia was 52.8 min.Conclusion Using 0.1% ropivacaine+0.5μg/ml sufentanil(8 ml/time),the effective programmed intermittent epidural bolus time interval in dural puncture epidural block for labor analgesia is 52.8 min.

关 键 词：分娩镇痛 硬膜外 硬脊膜穿破 脉冲注入 

分 类 号：R714.3[医药卫生—妇产科学]