目的：观察鞘内联合应用曲马多和右美托咪定对炎性疼痛大鼠的镇痛作用以及对细胞因子、免疫功能的影响。方法：雄性SD大鼠24只，随机分为对照组（C组）、右美托咪定组（D组）、曲马多组（T组）和小剂量右美托咪定联合曲马多组（F组）4组各6只。甲醛炎性致痛模型制备成功后，鞘内给药C组生理盐水10 μl、D组右美托咪定10 μg、T组曲马多10 μg、F组右美托咪定5 μg加曲马多5 μg，评估各组的镇痛效果，检测大鼠肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和T淋巴细胞亚群CD4⁺、CD8⁺的水平。结果：与C组比较，D组、T组、F组镇痛效果较好，F组最佳（P<0.05），D组、T组、F组间无明显差异（P>0.05）；D组、T组、F组血清TNF-α、IL-6水平较C组降低，F组降低更明显（P<0.05）；CD4⁺、CD8⁺表达水平在4组间差异无统计学意义（P>0.05）。结论：鞘内联合应用小剂量右美托咪定和曲马多不仅对炎性疼痛大鼠具有较好的协同镇痛作用，还能够抑制细胞因子的释放，对大鼠淋巴细胞亚群CD4⁺、CD8⁺的表达无影响。

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