Inclusion Criteria:  age 18 - 75 Elective orthopedic surgery patients for whom the use of propofol (10 mg/ml) in combination with remifentanil (20 mcg/ml) used in a single syringe in indicated  Exclusion Criteria:  True allergy to propofol/remifentanil Inability to understand pain scores and other questionnaires Inability to speak English Emergency surgery