Objective In anesthesia management for elderly patients undergoing laparoscopic cholecystectomy, whether the Index of Consciousness( IoC ) monitoring is superior to traditional Bispectral Index (BIS) anesthesia depth monitoring was evaluated by observing the dynamic changes in the systemic vascular resistance index (SVRI) in two groups of patients. Methods Elderly patients over 60 years old who underwent elective laparoscopic cholecystectomy were selected as the study subjects and randomly divided into two groups. One group received anesthesia management under the guidance of routine BIS monitoring; The other group used IoC monitoring to guide anesthesia management. The perioperative changes of SVRI, rate of change (ROC) of SVRI, the amounts of drugs administrated during the operation and postoperative recovery quality assessment were compared between the two groups during different perioperative events. Results There was no significant difference in general information, vital signs before anesthesia induction, and general information related to anesthesia and surgery between the two groups (p0.05). The fluctuation amplitude of SVRI dynamic monitoring value in group T was significantly lower than that in the group C, and was more stable than that in the group C during the perioperative period. The number of cases in group T with ROC of SVRI -30%/-50%/≥30% was significantly lower than that in group C, while the number of cases in group T with SVRI -10%≤ROC10% was higher than that in group C during perioperative events. Conclusions By observing the dynamic changes of SVRI in elderly patients undergoing cholecystectomy, it is found that the fluctuation range of SVRI in anesthesia management guided by IoC monitoring tends to be more stable than that guided by routine BIS monitoring. For elderly patients undergoing endoscopic cholecystectomy, anesthesia management guided by IoC monitoring can maintain the stability of vascular tension and thus maintain the stability of hemodynamics. So IoC monitoring may have better guiding value and application prospect in the management of anesthesia of elderly patients.