Postoperative pain management and recovery after remifentanil-based anaesthesia with isoflurane or propofol for major abdominal surgery

We have assessed if recovery times after morphine or fentanyl, given before terminating remifentanil anaesthesia with isoflurane or propofol, are comp romised. We studied patients undergoing elective, major abdominal surgery, allocated randomly to receive remifentanil and isoflurane (n = 277) or remi fentanil and propofol (n = 274) anaesthesia. Twenty-five minutes before the end of surgery, patients received fentanyl 0.15 mg or morphine 15 mg in a randomized, double-blind manner followed by a second dose (fentanyl 0.05 mg , morphine 7 mg) for moderate or severe pain in recovery. Recovery was rapi d and at an Aldrete score greater than or equal to 9 (median 12-15 min), 42 -51% of patients reported none or mild pain. However, 26-35% of patients re ported severe pain and >90% required a second dose of opioid within 21-27 m in after anaesthesia.