ANI-Guided Anesthetic Desflurane Consumption

General anesthesia requires precise titration of inhaled anesthetics like desflurane and opioids like remifentanil to balance sedation, analgesia, and hemodynamic stability. The Analgesia/Nociception Index (ANI), derived from heart rate variability (HRV), quantifies parasympathetic tone to assess nociception-antinociception balance on a 0-100 scale, with lower values indicating nociceptive stress. ANI analyzes high-frequency HRV components, reflecting parasympathetic inhibition during painful stimuli, making it a reliable indicator of intraoperative nociception. Studies validate the utility of ANI in detecting nociceptive events during laparoscopic surgery. ANI-guided opioid titration reduces opioid consumption and stabilizes hemodynamics, enhancing perioperative outcomes.

Inclusion Criteria: * aged 19-65 years, American Society of Anesthesiologists (ASA) physical status I-II, scheduled for elective laparoscopic cholecystectomy under general anesthesia. Exclusion Criteria: * chronic pain, preoperative opioid use, cardiac arrhythmias, autonomic dysfunction, or contraindications to desflurane or remifentanil.