Effects of propofol-remifentanil versus sevoflurane-remifentanil on acute postoperative pain after total shoulder arthroplasty: a randomized trial

BACKGROUND: While some evidence indicates that propofol-based anesthesia has less postoperative pain than sevoflurane-based anesthesia, these results are controversial. We compared acute postoperative pain intensity and opioid consumption after total shoulder arthroplasty between propofol-remifentanil (PR) and sevoflurane-remifentanil (SR) anesthesia. METHODS: Among 48 patients undergoing shoulder arthroscopic surgery anesthetized with PR or SR, postoperative pain intensity was assessed at 30 minutes and at 2, 6, 12, and 24 hours. The total patient-controlled analgesia volume and number of patients requiring rescue analgesics were assessed. RESULTS: No significant difference in postoperative pain intensity was observed between the two groups. Postoperative opioid consumption and analgesic requirements were also comparable in the first 24 hours after surgery. CONCLUSION: PR and SR anesthesia for shoulder arthroscopic surgery provide comparable postoperative analgesia results.