Remifentanil is an ultra-short acting opioid, and its use has been known to be related to acute opioid withdrawal or tolerance. This study was performed to compare the hemodynamic response, recovery characteristics, and postoperative pain response after sevoflurane-remifentanil or sevoflurane anesthesia in subtotal gastrectomy patients.

Sixty patients scheduled for gastrectomy were randomly allocated into two groups. Thoracic epidural catheterization was performed before anesthesia. Anesthesia was maintained with sevoflurane-remifentanil (SR group) or sevoflurane (SN group). We compared hemodynamic variables during surgery and recovery, the pain and sedation score during recovery, and the pain score and analgesic requirements during the postoperative period.

Intraoperative blood pressure and heart rates in the SR group were lower than in the SN group. There was no significant difference in extubation time and recovery time between patients in the two groups. The patients in the SN group showed more prompt recovery at 15 minutes after extubation. The VAS scores and analgesic demand of the SR group were greater than in the SN group.

Intraoperative use of remifentanil with sevoflurane may be related to increased postoperative pain.