[Abstract] Objective To investigate the effects of different target plasma remifentanil concentrations on the minimum alveolar concentration of sevoflurane (MACBAR) and minimum plasma catecholamine concentration for blocking adrenergic response (CatecholamineBAR: NEBAR, EBAR) in gynecological patients undergoing laparoscopic surgery using carbon dioxide pneumoperitoneum. Methods Seventy five cases of gynecological patients with ASAⅠ-Ⅱundergoing laparoscopic surgery were randomly assigned to three groups: control group (R0) and 2 remifentanil groups (R1, R2). Based on remifentanil plasma target controlled infusion (2ng/ml), Etomidate 0.3mg/kg was intravenously injected for anesthesia induction. Vecuronium 0.1mg/kg was injected for facilitate to tracheal intubation. After intubation anesthesia was maintained by inhaled sevoflurane vapor in all groups. But in R0, R1 and R2, the target plasma concentration of remifentanil was adjusted to 0,1 and 2ng/ml, respectively. The MACBAR of sevoflurane was determined by using a sequential design and pneumoperitoneum stimulation in each group, and blood samples were adopted at corresponding time points to determinate catecholamine concentrations and calculate the values of NEBAR, EBAR. Results In group R0, R1 and R2, the MACBARs of sevoflurane were (4.60 ± 0.30) %, (2.37 ± 0.21) % and (1.70 ± 0.28) %, respectively. No significant differences were found in NEBAR (R0: 291.25 ± 63.67 pg/ml, R1: 249.71 ± 68.68 pg/ml, R2: 256.42 ± 38.67pg/ml), EBAR (R0: 8.30 ± 2.36ng/ ml, R1: 6.94 ± 2.52ng/ml, R2: 7.69 ± 2.99ng/ml) and minimum MAP among the three groups. Conclusions The target plasma remifentanil concentrations of 1 ng/ml and 2 ng/ml can significantly reduce MACBAR of sevoflurane by 48% and 63% respectively in gynecological patients undergoing laparoscopic surgery. However, the value of catecholamineBAR was not affected by the changes of remifentanil’s target plasma concentration and the end-tidal sevoflurane concentration.