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 ComputJun 8, 2026 (epub)
Wei Liu, Ying Li, Ran Lin et al.
✦ AI-curated · Sources linked
In 30 seconds
This randomized controlled trial evaluated the opioid-sparing effect of Surgical Pleth Index (SPI)-guided analgesia in 61 patients undergoing laparoscopic gynecologic surgery. The SPI-directed group required significantly less intraoperative remifentanil (5.84 µg/kg/h vs. 6.96 µg/kg/h; P = 0.016). Additionally, a novel metric, Threshold-based Time-Weighted SPI (Tb-TW-SPI), showed potential for predicting postoperative pain.
Key findings
- The SPI-directed group required significantly less remifentanil: 5.84 µg/kg/h vs. 6.96 µg/kg/h; P = 0.016.
- Tb-TW-SPI values were significantly higher in patients with moderate-to-severe postoperative pain (NRS ≥ 4) compared to those without (P = 0.0417).
- The area under the ROC curve for Tb-TW-SPI predicting moderate-to-severe pain was 0.74 (95% CI: 0.52-0.96).
- At an optimal cutoff of 1210, Tb-TW-SPI had 67% sensitivity and 76% specificity for predicting postoperative pain.
Why it matters
The findings suggest that SPI-guided analgesia can effectively reduce opioid consumption during surgery, which may enhance patient safety and recovery. The potential predictive value of Tb-TW-SPI for postoperative pain could inform analgesic strategies.