大手术常会导致或加重呼吸功能不全，术后疼痛为常见原因之一。由于顾虑镇痛药物对病人呼吸的不良影响，特别是对合并呼吸功能不全者，临床医生更是不敢镇痛或镇痛不足，从而陷入“基础合并呼吸功能不全→手术打击及术后疼痛→加重呼吸功能不全”的恶性循环。可见，选择对呼吸系统负面影响最小，甚至能从机制上促进呼吸功能恢复的镇痛方式，对合并呼吸功能不全的病人具有重要意义。

Choice of analgesia patterns in postoperative patients with respiratory insufficiency        SHI Yan，LIU Da-wei. Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Corresponding author ：LIU Da-wei, E-mail：dwliu@medmail.com.cn
Abstract    Major surgical procedures usually cause or exacerbate respiratory insufficiency, and postoperative pain is one of the common reasons. However, clinicians seldom or never use any analgesics for such patients, when considering the respiratory side effects of the analgesics, as results in a vicious circle of “baseline respiratory insufficiency-surgical attack and postoperative pain-deteriorated respiratory insufficiency”. It is important to choose an appropriate postoperative analgesic pattern in patients with baseline respiratory insufficiency to promote their function recovery and to reduce postoperative complications.