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目的 探讨不同剂量右美托咪定复合舒芬太尼对腰椎手术患者术后镇痛的效果.方法 选择2014年8月至2016年8月腰椎术后自控静脉镇痛患者90例, ASAⅠ~Ⅱ级,随机分为三组,每组30例.右美托咪定0.6 μg/kg+舒芬太尼2 μg/kg+托烷司琼6 mg(D1组),右美托咪定1.5 μg/kg+舒芬太尼2 μg/kg+托烷司琼6 mg(D2组)和右美托咪定5 μg/kg+舒芬太尼2 μg/kg+托烷司琼6 mg(D3组).比较三组镇痛效果.结果 T4时点,Ramsay镇静评分 D1组与D3组比较,差异有统计学意义(P<0.05).术后恶心呕吐、心动过缓,D1组与D3组比较差异有统计学意义(P<0.05).结论 对于腰椎手术患者,术后镇痛泵中含右美托咪定1.5 μg/kg,可减少术后恶心呕吐,且对生命体征未见影响.“,”Objective To investigate the efficacy of different doses of dexmedetomidine combined with sufentanil on patient-controlled intravenous analgesia after lumbar surgery.Methods From August 2014 to August 2016, 90 cases (ASA Ⅱ-Ⅲ)with patient-controlled intravenous analgesia after lumbar surgery were selected and randomly divided into two groups, with 30 cases in each group.Patients in group D1 were treated with 0.6 μg/kg dexmedetomidine+2 μg/mg sufentanil+ 6 mg tropisetron, patients in group D2 were treated with 1.5 μg/kg dexmedetomidine+2 μg/mg sufentani+6 mg tropisetron, patients in group D3 were treated with 5 μg/kg dexmedetomidine+2 μg/mg sufentanil +6 mg tropisetron. The analgesic effects were compared among the three groups.Results At T4, the difference of Ramsay scores between group D1 and group D3 was significant (P<0.05).The incidences of nausea and vomiting, bradycardia between group D1 and group D3 were significantly different (P<0.05).Conclusion 1.5 μg/kg dexmedetomidine can reduce the rate of postoperative nausea and vomiting, and without affecting the vital signs.