Razavi Journal of Medicine

Razavi Journal of Medicine

Effect of Intraoperative Remifentanil on Postoperative Pain and Analgesic Requirements in Colorectal Surgery: A Cohort Study

Articles in Press

Document Type : Original Article

Authors
Mohsen Saber Moghadam 1
Seyed Javad Purafzali Firuzabadi 1
Maryam Emadzadeh 2, 3
Bentolhoda Ebrahimi 1
1 Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
10.30483/rjm.2026.254739.1496
Abstract
Background: Remifentanil is an ultra-short-acting, high-potency opioid. Short-acting drugs such as Remifentanil can cause acute drug tolerance or opioid-induced hyperalgesia, thereby affecting postoperative pain.

Objective: This study aimed to compare postoperative pain in patients receiving propofol-remifentanil anesthesia versus Propofol alone.

Methods & Materials: This cohort study was performed on 35 patients admitted to the central operating room of Ghaem Hospital. Samples were selected from among the patients for two groups: those receiving Remifentanil plus Propofol and those receiving Propofol alone during surgery. The amount of analgesia received was recorded at 0, 30, 60, 120 minutes, and 6 and 12 hours after surgery. The patient's pain was also assessed using the VAS questionnaire at the same time. Data were analyzed using SPSS software version 23.

Results: In total, 60% (21 patients) were male, and 40% (14 patients) were female, with a mean age of 56.88 ± 17.88 years. The two groups were homogeneous in terms of age, sex, and weight. The two groups were also not statistically different in surgery duration, duration of anesthesia, or propofol dose. No significant difference was observed between the two groups in terms of intravenous Acetaminophen and meperidine intake at 0, 30, 60, 120 minutes, 6 hours, and 12 hours. There was no significant difference between the two groups in terms of ketorolac 30 mg and methadone. Although VAS scores in the Remifentanil + propofol group were lower than those in the propofol group at the final time points of 2, 6, and 12 hours, group (Propofol only or Remifentanil + propofol) did not affect VAS scores.

Conclusion: The study results showed that when an intermediate dose of Remifentanil (0.1 µg/kg/min) was combined with Propofol, no evidence of post-operative hyperalgesia was observed. Therefore, it is recommended that Remifentanil be preferably used in combination with Propofol.
Keywords
Hyperalgesia
Remifentanil
Propofol
pain

Acknowledgement: The authors would like to thank the Clinical Research Development Unit of Ghaem Hospital for cooperation in data analysis.This study was conducted as part of the corresponding author's clinical medical specialty thesis. Mashhad University of Medical Sciences financially supported it.


Ethical Considerations: All procedures were conducted in accordance with the Declaration of Helsinki. This study was reviewed and approved by the Ethics Committee of Mashhad University of Medical Sciences with the approval code IR.MUMS.MEDICAL.REC.1398.325. Informed consent was obtained from all patients before they participated in the study. Patients were assured that their information would remain confidential.


Data Availability Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/


Conflicts of Interest: The authors declare that they have no conflicts of interest.


Funding: This study was conducted as part of the corresponding author’s clinical medical specialty thesis and was financially supported by Mashhad University of Medical Sciences, Mashhad, Iran.


Consent for Publication: Not applicable.


Author Contributions: S.J.P.F.: Conceptualization, study design, data collection, and manuscript preparation.B.E.: Methodology, data collection, and investigation.M.E.: Statistical analysis, data interpretation, and manuscript review.M.S.M.: Supervision, critical revision of the manuscript, and final approval of the version to be published. All authors contributed to the study, critically reviewed the manuscript, approved the final version, and agreed to be accountable for all aspects of the work.

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Razavi Journal of Medicine

Articles in Press, Accepted Manuscript
Available Online from 20 August 2026