【Abstract】 Objective To investigate the effect of using the index of consciousness (IoC) 2 to guide the use of intraoperative analgesic drugs on patients during laparoscopic ovarian cyst exfoliation. Methods A total of 102 American Society of Anesthesiologists (ASA)Ⅰ or Ⅱ level patients undergoing elective laparoscopic ovarian cyst exfoliation were randomly divided into control group (group C) and experimental group (group T) by the random number table method. Induction and maintenance of anesthesia were continually pumping propofol and remifentanil， and sedation was guided by the value of IoC1 (40‒60). Remifentanil dosage in group C was adjusted based on the anesthesiologist's experience; in group T, the dose of remifentanil was adjusted according to IoC2 (30‒50). Intraoperatively, atropine and vasoactive drugs were used to maintain circulation stability. Mean arterial pressure (MAP) and heart rate were recorded before anesthesia, 1 min after an operation, 30 min after the operation, in the end, and 5 min after extubation. The frequency of blood pressure and heart rate fluctuations exceeding 20% of the basal value was also recorded. The operation time, intraoperative blood loss and infusion volume, the time from the end of operation to extubation, and the perioperative dosage of propofol, remifentanil, ephedrine, atropine, urapidil, and esmolol were recorded. The Numerical Rating Scale (NRS) scores after extubation, during post‑anesthesia care unit (PACU), and on a postoperative day 1 were recorded, and the blood glucose levels after entering the room and at the end of the operation were recorded. Results The results showed no statistically significant difference between the two groups was found in the general and surgical data (P>0.05). Compared with before anesthesia, there were significant differences in MAP and heart rate at each time point (P<0.05). MAP and heart rate in group C were significantly higher than in group T at 1 min, 30 min, end of the operation, and 5 min after extubation (P<0.05). The incidence of bradycardia in group C was lower than that in group T (P<0.05), and the incidence of hypertension in group C was higher than that in group T (P<0.05). Compared with group C, the intraoperative dosage of remifentanil and atropine in group T was increased (P<0.05), and the dosage of yanidine was significantly decreased (P<0.05). After extubation and on a postoperative day 1, the NRS score of group T was lower than that of group C (P<0.05). Blood glucose in group T was lower than in group C at the end of the operation (P<0.05). There was no significant difference in other indexes. Conclusions To conclude, using IoC2 to guide perioperative analgesia management during laparoscopic ovarian cyst exfoliation can make hemodynamics more stable, reduce perioperative blood glucose fluctuation, can relieve the incidence of postoperative pain.