Application of Surgical Pleth Index (SPI)-guided analgesia in laparoscopic gynecologic surgery: a randomized controlled trial evaluating the remifentanil-sparing effect and predictive value of time-weighted SPI
Authors' conclusion
This RCT suggests that SPI-directed analgesia can safely and moderately reduce intraoperative remifentanil consumption.
Study context
- Population
- Patients undergoing elective laparoscopic gynecologic surgery
- Participants
- 61 patients
- Comparison
- SPI-directed analgesia vs conventional analgesia
- Primary endpoint
- Total intraoperative remifentanil consumption
Methodological detailsexploratory analysis
- Exploratory analysis
Primary result
As reported in the abstract
Intraoperative remifentanil consumption
P = 0.016
Further findings
| Outcome | Values | P value |
|---|---|---|
| Postoperative pain scores | P > 0.05 | |
| Tb-TW-SPI in patients with vs without moderate-to-severe PACU pain (NRS ≥ 4), conventional groupExploratory analysis | P = 0.0417 | |
| Tb-TW-SPI predicting moderate-to-severe pain (NRS ≥ 4)Exploratory analysis | Tb-TW-SPI AUC 0.74 (95% CI: 0.52-0.96) · sensitivity 67% · specificity 76% · optimal cutoff 1210 |
Postoperative pain scores
- No significant difference between groups
Threshold-based Time-Weighted SPI (Tb-TW-SPI) in patients with vs without moderate-to-severe post-anesthesia care unit (PACU) pain (Numeric Rating Scale (NRS) ≥ 4), conventional group
- Tb-TW-SPI significantly higher with moderate-to-severe pain
Original publication
Application of SPI-guided analgesia in laparoscopic gynecologic surgery: a randomized controlled trial evaluating the remifentanil-sparing effect and predictive value of time-weighted SPI. J Clin Monit Comput. Published 8 June 2026. doi:10.
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