This study was designed to investigate qCON and qNOX variations during outpatient laparoscopic cholecystectomy using remifentanil and desflurane without muscle relaxants and compare these indices with ANI and MAC. Adult patients undergoing outpatient laparoscopic cholecystectomy were included in this prospective observational study. Maintenance of anesthesia was performed using remifentanil targeted to ANI 50–80 and desflurane targeted to MAC 0.8–1.2 without muscle relaxants. The ANI, qCON and qNOX and desflurane MAC values were collected at different time-points and analyzed using repeated measures ANOVA. The relationship between ANI and qNOX and between qCON and MAC were analyzed by linear regression. The ANI was comprised between 50 and 80 during maintenance of anesthesia. Higher values of qNOX and qCON were observed at induction and extubation than during all other time-points where they were comprised between 40 and 60. A poor but significant negative linear relationship (r² = 0.07, p < 0.001) was observed between ANI and qNOX. There also was a negative linear relationship between qCON and MAC (r² = 0.48, p < 0.001) and between qNOX and remifentanil infusion rate (r² = 0.13, p < 0.001). The linear mixed-effect regression correlation (r²) was 0.65 for ANI-qNOX and 0.96 for qCON-MAC. The qCON and qNOX monitoring seems informative during general anesthesia using desflurane and remifentanil without muscle relaxants in patients undergoing ambulatory laparoscopic cholecystectomy. While qCON correlated with MAC, the correlation of overall qCON and ANI was poor but significant. Additionally, the qNOX weakly correlated with the remifentanil infusion rate. This observational study suggests that the proposed ranges of 40–60 for both indexes may correspond to adequate levels of hypnosis and analgesia during general anesthesia, although this should be confirmed by further research.

本研究旨在调查门诊腹腔镜胆囊切除术中 qCON 和 qNOX 的变化，使用瑞芬太尼和地氟烷而不使用肌肉松弛剂，并将这些指标与 ANI 和 MAC 进行比较。接受门诊腹腔镜胆囊切除术的成年患者被纳入这项前瞻性观察研究。使用针对 ANI 50-80 的瑞芬太尼和针对 MAC 0.8-1.2 的地氟醚进行麻醉维持，不含肌肉松弛剂。在不同时间点收集 ANI、qCON 和 qNOX 以及地氟醚 MAC 值，并使用重复测量方差分析进行分析。通过线性回归分析ANI与qNOX之间以及qCON与MAC之间的关系。在麻醉维持期间，ANI 介于 50 和 80 之间。²  = 0.07，p < 0.001) 在 ANI 和 qNOX 之间观察到。^{qCON 和 MAC 之间（r 2}  = 0.48，p < 0.001）以及 qNOX 和瑞芬太尼输注率之间也存在负线性关系（r ²  = 0.13，p < 0.001）。线性混合效应回归相关性 (r ²) 对于 ANI-qNOX 为 0.65，对于 qCON-MAC 为 0.96。在接受门诊腹腔镜胆囊切除术的患者中，在不使用肌肉松弛剂的情况下使用地氟醚和瑞芬太尼进行全身麻醉期间，qCON 和 qNOX 监测似乎可以提供信息。虽然 qCON 与 MAC 相关，但总体 qCON 和 ANI 的相关性较差但显着。此外，qNOX 与瑞芬太尼的输注速度弱相关。这项观察性研究表明，这两个指数的建议范围 40-60 可能对应于全身麻醉期间适当的催眠和镇痛水平，尽管这应该通过进一步的研究来证实。