Effect of IoC2-guided analgesic titration on intraoperative opioid consumption in older patients undergoing…

Randomized trialJournal of anesthesia· Jul 2026

Effect of IoC2-guided analgesic titration on intraoperative opioid consumption in older patients undergoing laparoscopic colorectal surgery: a randomized controlled trial.

Tianran Gang, Zhe Li, Yanting Cao … Xiaowen Liu

Perioperative MedicineRandomized trialTreatmentQ1IF 2.3

IoC2-guided dosing lowered intraoperative sufentanil use in older colorectal surgery patients

Effect of IoC2-guided analgesic titration on intraoperative opioid consumption in older patients undergoing laparoscopic colorectal surgery: a randomized controlled trial.

Tianran Gang … Xiaowen Liu

Journal of anesthesia · Jul 2026 · Q1 in Anesthesiology

Purpose

Hemodynamic variables may be unreliable indicators of intraoperative nociception in older patients.

Methods

In this prospective, single-center, parallel-group, single-blind randomized trial, patients aged 65-90 years with ASA physical status II-III undergoing elective laparoscopic colorectal resection were randomized 1:1 to IoC2-guided or hemodynamic-guided analgesia.

n = 28

Results

IoC2-guided dosing meant lower opioid use during surgery

IoC2

0.1μg/kg/

Control

0.17μg/kg/

More results

Total intraoperative sufentanil dose was also lower in the IoC2 group (20.0 [16.9-26.3] vs 36.0 [27.8-44.4] μg; p < 0.001).

Postoperative pain scores and sufentanil requirements were similar between groups, with no significant differences in hypotension, bradycardia, vasoactive drug use, baseline-adjusted interleukin-6 concentrations, or delirium.

More results

PACU postoperative nausea and vomiting was less frequent in the IoC2 group (3.6% vs 30.0%; p = 0.012).

“

Conclusion · 1 of 3

A prespecified IoC2-based sufentanil dosing protocol reduced weight- and time-normalized intraoperative sufentanil consumption without worsening early postoperative pain outcomes in older patients undergoing laparoscopic colorectal surgery.

Conclusion · 2 of 3

This finding should be interpreted as the effect of the tested dosing protocol rather than validation of the IoC2 target range or treatment threshold.

Conclusion · 3 of 3

The lower PACU postoperative nausea and vomiting incidence was a secondary finding and requires confirmation in larger trials.

Effect of IoC2-guided analgesic titration on intraoperative opioid consumption in older patients undergoing laparoscopic colorectal surgery: a randomized controlled trial.

Effect of IoC2-guided analgesic titration on intraoperative opioid consumption in older patients undergoing laparoscopic colorectal surgery: a randomized controlled trial.

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