目的 观察丙帕他莫复合芬太尼对腰椎术后镇痛的应用效果。方法 60例接受腰椎手术患者随机分成2组，每组30例。Ⅰ组手术结束前15 min给予丙帕他莫2 g，术后予芬太尼患者自控镇痛(PCA)泵静脉镇痛， Ⅱ组术后给予芬太尼PCA泵静脉镇痛。两组泵中芬太尼都按0.4 μg·kg^-1·h^-1配置，使用48 h。观察两组患者术后拔除气管导管时间，术后48 h内各时间点的镇痛镇静评分、呼吸循环指标以及术后呕吐发生情况。结果 两组患者术后拔管时间、术后各时间点镇静评分、呼吸频率、平均动脉压、心率及呕吐发生率比较差异均无统计学意义（P>0.05）。术后30 min和1、2、4、6及12 h时间点，Ⅰ组镇痛评分优于Ⅱ组（P<0.05），其余时间点两组镇痛评分比较差异无统计学意义（P>0.05）。结论 丙帕他莫复合芬太尼用于腰椎术后患者镇痛安全有效。

Objective To assess the analgesic effects of propacetamol with fentanyl after lumbar spine surgery. Methods Sixty patients undergoing lumbar spine surgery were randomly divided into two groups, with 30 patients in each group. Patients in group Ⅰ were treated with 2 g propacetamol 15 min before the end of operation, and were managed with self-controlled analgesia (PCA) pump with fentanyl after operation. Patients in group Ⅱ were just given PCA pump with fentanyl after operation. PCA pumps were composed of fentanyl with 0.4 μg·kg^-1·h^-1, and were used for 48 h. The time of extubation after operation and the analgesia scores, sedation scores, respiration, circulation, vomiting at different time points within 48 h after operation in two groups were recorded. Results There was no significant difference in the time of extubation, and sedation scores, respiration, mean arterial pressure, heart rates and vomiting at different time points after operation between two groups (P>0.05). The analgesia scores in group Ⅰ were superior to those in group Ⅱ at the time points of 30 min, 1 h, 2 h, 4 h, 6 h and 12 h after operation （P<0.05）, while there was no significant difference in the analgesia scores between two groups at the other time points (P>0.05). Conclusion The analgesic effect of propacetamol with fentanyl after surgery is safe and effective.