Using AnalgesiaNociception Index to Guide Desflurane Anesthesia for Laparoscopic Gallbladder Surgery A Randomized Trial to Reduce Anesthetic Use and Improve Recovery

What this Trial Is About

This research evaluates the use of the AnalgesiaNociception Index ANI to guide desflurane anesthesia during laparoscopic cholecystectomy in adults aged 19 to 65 years with good physical health ASA I-II. ANI measures parasympathetic tone to assess pain and analgesia balance, aiming to improve opioid titration, reduce anesthetic consumption, and stabilize hemodynamics during surgery. Participants are randomly assigned to either an ANI-guided group or a standard care group. Both groups receive general anesthesia with propofol induction followed by maintenance with desflurane and remifentanil. The ANI-guided group adjusts desflurane doses based on ANI values and BIS monitoring, while the control group follows standard vital sign and BIS-based titration. ANI is monitored in both groups but only guides dosing in the ANI group. Recovery includes neuromuscular monitoring and use of sugammadex for muscle relaxation reversal. During the study, participants undergo continuous monitoring of heart rate variability, blood pressure, and baroreflex sensitivity to assess autonomic function. Outcomes measured include desflurane concentration, emergence time, postoperative pain, hemodynamic stability, length of stay in recovery, need for additional pain medications, nausea and vomiting incidence, and patient satisfaction. Data collection spans from anesthesia induction through surgery and up to 24 hours postoperatively, with safety and recovery closely tracked.

ANI-Guided Anesthetic Desflurane Consumption