Application of Different Doses of Remifentanil Combined with Sevoflurane in Ambulatory Laparoscopic Cholecystectomy under Pain Threshold Index Monitoring

Jiaqi LIU; Siqi GAO; Ningli ZHANG; Jie OUYANG; Jun JIANG; Yuan LI; Fuquan LI; Chen ZHOU

doi:10.12259/j.issn.2095-610X.S20250619

Volume 46 Issue 6

Jun. 2025

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Article Navigation > Journal of Kunming Medical University > 2025 > 46(6): 149-155

Jiaqi LIU, Siqi GAO, Ningli ZHANG, Jie OUYANG, Jun JIANG, Yuan LI, Fuquan LI, Chen ZHOU. Application of Different Doses of Remifentanil Combined with Sevoflurane in Ambulatory Laparoscopic Cholecystectomy under Pain Threshold Index Monitoring[J]. Journal of Kunming Medical University, 2025, 46(6): 149-155. doi: 10.12259/j.issn.2095-610X.S20250619

Citation:

Jiaqi LIU, Siqi GAO, Ningli ZHANG, Jie OUYANG, Jun JIANG, Yuan LI, Fuquan LI, Chen ZHOU. Application of Different Doses of Remifentanil Combined with Sevoflurane in Ambulatory Laparoscopic Cholecystectomy under Pain Threshold Index Monitoring[J]. Journal of Kunming Medical University, 2025, 46(6): 149-155. doi: 10.12259/j.issn.2095-610X.S20250619

Citation:

Jiaqi LIU, Siqi GAO, Ningli ZHANG, Jie OUYANG, Jun JIANG, Yuan LI, Fuquan LI, Chen ZHOU. Application of Different Doses of Remifentanil Combined with Sevoflurane in Ambulatory Laparoscopic Cholecystectomy under Pain Threshold Index Monitoring[J]. Journal of Kunming Medical University, 2025, 46(6): 149-155. doi: 10.12259/j.issn.2095-610X.S20250619

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Application of Different Doses of Remifentanil Combined with Sevoflurane in Ambulatory Laparoscopic Cholecystectomy under Pain Threshold Index Monitoring

doi: 10.12259/j.issn.2095-610X.S20250619

1.
Department of Thyroid and Breast Surgery，The Second Affiliated Hospital，Kunming Medical University，Kunming Yunnan 650101
2.
Anesthesiology Department，Lijiang People’s Hospital，Lijiang Yunnan 674000
3.
Anesthesia and Surgery Department，The Second Affiliated Hospital，Kunming Medical University，Kunming Yunnan 650101，China

Received Date: 2025-01-24
Publish Date: 2025-06-25

Abstract

Abstract

Objective To investigate the application value of different doses of remifentanil combined with sevoflurane under pain threshold index （PTi） monitoring in ambulatory laparoscopic cholecystectomy. Methods 152 patients undergoing laparoscopic cholecystectomy under general anesthesia were selected from December 2023 to June 2024 at the Second Affiliated Hospital of Kunming Medical University. Patients were randomly divided into R₁ group （n = 38）, R₂ group （n = 38）, R₃ group （n = 38）, and R₄ group （n = 38） using a random number table. On the basis of sevoflurane at 0.7 minimum alveolar concentration （MAC）, patients in R₁～R₄ groups were combined with 0.1, 0.2, 0.3, and 0.4 μg/kg·min remifentanil, respectively. The changes in PTi at different time points, pre- and post-operative blood stress indicators [cortisol （Cor）, norepinephrine （NE）, and blood glucose （Glu） concentrations] were compared, and the incidence of intraoperative hypertension, hypotension, tachycardia, bradycardia, and postoperative nausea and vomiting were recorded. Results Compared with R₁ group, PTi in R₂, R₃, and R₄ groups decreased from the start of surgery （T₃） to 5 min after extubation （T₁₁）（P < 0.05）; compared with R₂ group, PTi in R₃ and R₄ groups was lower at T₃～T₁₁ （P < 0.05）; no statistically significant difference was found in PTi changes between R₃ and R₄ groups at different time points （P > 0.05）. Postoperative Cor, NE, and Glu concentrations showed statistically significant differences among the four groups （P < 0.001）, but no significant difference was found preoperatively （P > 0.05）. Compared with preoperative values, Cor, NE, and Glu levels significantly increased in all groups （P < 0.001）, with R₁ group > R₂ group > R₄ group > R₃ group. The incidence of intraoperative hypertension, hypotension, bradycardia, and tachycardia showed statistically significant differences （P < 0.001）, with R₄ > R₁ > R₂ = R₃. The incidence of postoperative nausea and vomiting also showed statistically significant differences （P < 0.001）, with R₁ group > R₄ group > R₂ group > R₃ group. Conclusion Sevoflurane at 0.7 MAC combined with 0.3 μg/kg·min remifentanil provides good analgesic effects for patients undergoing ambulatory laparoscopic cholecystectomy, reduces stress response, and has high safety, making it worthy of clinical promotion.
- Sevoflurane,
- Remifentanil,
- General anesthesia,
- Pain threshold index,
- Laparoscopy,
- Cholecystectomy

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