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目的:观察面肌痉挛微血管减压术后应用不同剂量舒芬太尼镇痛方案对术后恶心呕吐不良反应的影响。方法:回顾性纳入行微血管减压术的面肌痉挛女性患者183例，在相同麻醉方法的基础上根据术后是否使用舒芬太尼镇痛泵及其不同剂量将患者分为舒芬太尼2 μg/kg组（A组，60例）、舒芬太尼1 μg/kg组（B组，60例）和未使用镇痛泵组（C组，63例）。主要观察指标为3组患者术后2、8、24 h恶心呕吐的发生率。次要观察指标为3组患者手术时间，麻醉时间，术后2、8、24 h的VAS疼痛评分等级。结果:A组患者术后2、8、24 h恶心呕吐发生率高于B组（2 h n χ2=5.67，n P=0.017; 8 h n χ2=8.57，n P=0.003; 24 h n χ2= 6.72，n P=0.010）。A组患者术后2、8、24 h恶心呕吐发生率高于C组（2 h n χ2 =4.47，n P=0.034；8 h n χ2=4.55，n P=0.033；24 h n χ2 =5.01，n P= 0.025）。B组与C组患者各时点恶心呕吐发生率差异无统计学意义（2 h n χ2=0.09，n P=0.764; 8 h n χ2 =0.72，n P=0.395; 24 h n χ2=0.16，n P= 0.691）。术后2 h，三组患者VAS疼痛评分无痛差异无统计学意义（n P>0.01），C组轻至重度疼痛评分等级高于A组（n Z=7.12，n P0.01); the grade of mild to severe pain in group C was higher than that in group A (n Z=7.12, n P<0.001) and group B (n Z=6.06, n P0.01), and the grade of mild to severe pain in group C was higher than that in group B (n Z= 5.50, n P<0.001); the grade of pain in group C was higher than that in group A (n Z=6.45, n P<0.001); and there was no significant difference between group A and group B (n Z=1.69, n P=0.091). Then, 24 h after operation, the VAS score in group C was higher than that in group A (n Z=5.62, n P<0.001) and group B (n Z=5.30, n P0.05).n Conclusions:After microvascular decompression for hemifacial spasms, the application of 1 μg/kg sufentanil postoperative analgesia can effectively reduce the postoperative VAS score without increasing the incidence of postoperative nausea and vomiting.