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目的 观察丙泊酚联合不同剂量瑞芬太尼对患者疼痛敏感度的影响.方法 76例全身麻醉手术治疗的患者随机分为试验组和对照组,每组38例.试验组瑞芬太尼用量为4 ng·mL-1,对照组瑞芬太尼用量为2 ng·mL-.对患者用药前、插管前、插管后2,4,6 min的平均动脉压、舒张压、收缩压及心率进行记录,比较2组患者的疼痛分级与药物不良反应的发生情况.结果 试验组的无痛发生率为76.32％(29/38例),对照组为26.31％(10/38例,P＜0.05).插管前、插管后2,4,6 min,2组患者的平均动脉压、舒张压、收缩压、心率均呈不同程度的降低趋势.插管后6 min,试验组的平均动脉压为(74.32±6.66)mmHg,舒张压为(68.56±6.11)mmHg,收缩压为(96.86±14.65) mmHg,心率为(61.11 ±6.42)times·min-1;对照组分别为(75.53±7.11),(65.35±5.53),(95.32±13.53) mmHg和(62.42±5.21)times·min-1,差异均无统计学意义(均P ＞0.05);2组与治疗前相比,差异均有统计学意义(均P＜0.05).试验组出现发热1例、呼吸抑制1例、恶心2例、呕吐2例,药物不良反应发生率为15.79％(6/38例);对照组出现呕吐1例、眩晕1例、恶心2例、呼吸抑制3例,药物不良反应发生率为18.42％(7/38例),差异无统计学意义(P＞0.05).结论 2,4 ng·mL-1的瑞芬太尼均能减慢患者的心率,降低血压水平,但瑞芬太尼的药物用量为4 ng·mL-时,更能有效缓解患者注射丙泊酚的疼痛敏感度.“,”Objective To observe the effect of propofol combined with different doses of remifentanil on pain sensitivity.Methods A total of 76 patients undergoing general anesthesia were randomly divided into treatment group and control group,38 cases in each group.Treatment group was given 4 ng · mL-1 remifentanil.Control group was given 2 ng·mL-1 remifentanil.The mean arterial pressure,diastolic blood pressure,systolic blood pressure and heart rate were recorded before treatment and before intubation,2,4,6 min after intubation pain severity and adverse drug reactions were compared between the two groups.Results The incidence of painlessness were 76.32％ (29/38 cases) in treatment group and 26.31％ (10/38 cases) in control group (P ＜ 0.05).The mean arterial pressure,diastolic blood pressure,systolic blood pressure and heart rate of the patients in two groups after 2,4 and 6 min intubation were significantly decreased in different degrees.The mean arterial pressure,diastolic blood pressure,systolic blood pressure,heart rate in treatment group were (74.32 ± 6.66) mmHg,(68.56 ± 6.11) mmHg,(96.86 ± 14.65) mmHg,(61.11 ±6.42)times · min-1 The mean arterial pressure,diastolic blood pressure,systolic blood pressure,heart rate in control group were (75.53 ± 7.11) mmHg,(65.35 ± 5.53) mmHg,(95.32 ± 13.53) mmHg,(62.42 ± 5.21) times · min-1,the differences had no statistically significance (P ＞0.05).But,there was significant difference compared with those before treatment in two groups (P ＜ 0.05).There were 1 case of fever,1 case of respiratory depression,2 cases of nausea,2 cases of vomiting in treatment group,the incidence of adverse drug reactions was 15.79％ (6/38 cases).In control group,there were 1 case of vomiting,1 case of vertigo,2 cases of nausea,3 cases of respiratory depression,the incidence of adverse drug reactions was18.42％ (7/38 cases,P ＞ 0.05).Conclusion Remifentanil 2,4 ng· mL-1 can decrease the heart rate and blood pressure of the patients,but the remifentanil dose of 4 ng · mL-1 was more effective in relieving pain sensitivity in patients with the injection of propofol.