Seasonal variation of melatonin secretion across various segments of the gastrointestinal tract in rats

Objective:To investigate whether melatonin(MT)secretion in different parts of the gastrointestinal tract(GIT)exhibits seasonal variations and its correlation with immune regulation.Methods: Sixty Sprague-Dawley rats were divided into control and model groups,and the pineal gland was removed in the model group.Stomach,jejunum,ileum,and colon tissues were obtained during the spring equinox,summer solstice,beginning of autumn,autumn equinox,and winter solstice.The levels of MT,MT receptors(MR),arylalkylamine N-acetyltransferase(AANAT),hydroxyindole-O-methyltransferase(HIOMT),interleukin-2(IL-2),and interleukin-10(IL-10)in the GIT were measured using enzyme-linked immunosorbent assay.Results: Except for the stomach,the jejunum,ileum,and the colon showed seasonal tendencies in MT secretion.In the control group,MT secretion in the jejunum and ileum was the highest in the long summer,and colonic MT secretion was the highest in winter.In the model group,MT levels in the colon were highest in the summer.The seasonal rhythms of the MR,AANAT,HIOMT,IL-2,and IL-10 in the colon were roughly similar to those of MT,and changed accordingly after pinealectomy.Conclusions: Gastrointestinal MT secretion is related to seasonal changes,and MT secretion in each intestinal segment is influenced by different seasons.The biological effects of MT in the gut are inextricably linked to the mediation of MR,and a hormone-receptor linkage exists between MT and MR.The effect of seasonal changes on the gastrointestinal immune system may be mediated through the regulation of seasonal secretion of MT.

Advances in epidural labor analgesia:Effectiveness and treatment strategies of butorphanol

In this editorial,we provide a critical review of the article by Tang et al published in the World J Clin Cases,focusing on the utilization of butorphanol for epidural analgesia during labor.Our discussion encompasses recent research developments in epidural labor analgesia,specifically highlighting the current status of clinical applications of butorphanol and associated treatment approaches.Epidural analgesia is widely acknowledged as the primary method for pain management during labor,offering effective and prolonged pain relief while allowing mothers to remain alert and actively participate in the delivery process.Among the various drugs utilized for epidural labor analgesia,butorphanol has received increasing attention due to its potential efficacy and distinctive pharmacological properties.As a synthetic opioid analgesic,butorphanol exhibits both agonistic and antagonistic activity on opioid receptors,striking a balance between analgesia and minimizing side effects.Nevertheless,the safety and efficacy of butorphanol in epidural labor analgesia remains controversial.While certain studies have reported positive outcomes with butorphanol,including effective pain relief and a reduced incidence of side effects,others have raised concerns about its safety and efficacy compared to traditional opioids or alternative analgesics.In addition,the optimal dosing strategy and regimen of butorphanol as an adjuvant in epidural labor analgesia still need to be verified.Through comprehensive synthesis and analysis of existing literature,we aim to evaluate the current evidence regarding the use of butorphanol for epidural labor analgesia,delineate areas of consensus and controversy,and propose future avenues for research and clinical practice in this domain.

Safety and effectiveness of butorphanol in epidural labor analgesia:A protocol for a systematic review and meta-analysis

BACKGROUND Epidural analgesia is the most effective analgesic method during labor.Butorphanol administered epidurally has been shown to be a successful analgesic method during labor.However,no comprehensive study has examined the safety and efficacy of using butorphanol as an epidural analgesic during labor.AIM To assess butorphanol's safety and efficacy for epidural labor analgesia.METHODS The PubMed,Cochrane Library,EMBASE,Web of Science,China National Knowledge Infrastructure,and Google Scholar databases will be searched from inception.Other types of literature,such as conference abstracts and references to pertinent reviews,will also be reviewed.We will include randomized controlled trials comparing butorphanol with other opioids combined with local anesthetics for epidural analgesia during labor.There will be no language restrictions.The primary outcomes will include the visual analog scale score for the first stage of labor,fetal effects,and Apgar score.Two independent reviewers will evaluate the full texts,extract data,and assess the risk of bias.Publication bias will be evaluated using Egger's or Begg's tests as well as visual analysis of a funnel plot,and heterogeneity will be evaluated using the Cochran Q test,P values,and I2 values.Meta-analysis,subgroup analysis,and sensitivity analysis will be performed using RevMan software version 5.4.This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)Protocols statement,and the PRISMA statement will be used for the systematic review.RESULTS This study provides reliable information regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.CONCLUSION To support clinical practice and development,this study provides evidence-based findings regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.

Exogenous melatonin improves cotton yield under drought stress by enhancing root development and reducing root damage

The exogenous application of melatonin by the root drenching method is an effective way to improve crop drought resistance.However,the optimal concentration of melatonin by root drenching and the physiological mechanisms underlying melatonin-induced drought tolerance in cotton(Gossypium hirsutum L.)roots remain elusive.This study determined the optimal concentration of melatonin by root drenching and explored the protective effects of melatonin on cotton roots.The results showed that 50μmol L-1 melatonin was optimal and significantly mitigated the inhibitory effect of drought on cotton seedling growth.Exogenous melatonin promoted root development in drought-stressed cotton plants by remarkably increasing the root length,projected area,surface area,volume,diameter,and biomass.Melatonin also mitigated the drought-weakened photosynthetic capacity of cotton and regulated the endogenous hormone contents by regulating the relative expression levels of hormone-synthesis genes under drought stress.Melatonin-treated cotton seedlings maintained optimal enzymatic and non-enzymatic antioxidant capacities,and produced relatively lower levels of reactive oxygen species and malondialdehyde,thus reducing the drought stress damage to cotton roots(such as mitochondrial damage).Moreover,melatonin alleviated the yield and fiber length declines caused by drought stress.Taken together,these findings show that root drenching with exogenous melatonin increases the cotton yield by enhancing root development and reducing the root damage induced by drought stress.In summary,these results provide a foundation for the application of melatonin in the field by the root drenching method.

Exercise-with-melatonin therapy improves sleep disorder and motor dysfunction in a rat model of ischemic stroke

Exercise-with-melatonin therapy has complementary and synergistic effects on spinal cord injury and Alzheimer's disease,but its effect on stroke is still poorly understood.In this study,we established a rat model of ischemic stroke by occluding the middle cerebral artery for 60 minutes.We treated the rats with exercise and melatonin therapy for 7 consecutive days.Results showed that exercise-with-melatonin therapy significantly prolonged sleep duration in the model rats,increased delta power values,and regularized delta power rhythm.Additionally,exercise-with-melatonin therapy improved coordination,endurance,and grip strength,as well as learning and memory abilities.At the same time,it led to higher hippocampal CA1 neuron activity and postsynaptic density thickness and lower expression of glutamate receptor 2 than did exercise or melatonin therapy alone.These findings suggest that exercise-withmelatonin therapy can alleviate sleep disorder and motor dysfunction by increasing glutamate receptor 2 protein expression and regulating hippocampal CA1 synaptic plasticity.

Melatonin improves synapse development by PI3K/Akt signaling in a mouse model of autism spectrum disorder

Autism spectrum disorders are a group of neurodevelopmental disorders involving more than 1100 genes,including Ctnnd2 as a candidate gene.Ctnnd2knockout mice,serving as an animal model of autis m,have been demonstrated to exhibit decreased density of dendritic spines.The role of melatonin,as a neuro hormone capable of effectively alleviating social interaction deficits and regulating the development of dendritic spines,in Ctnnd2 deletion-induced nerve injury remains unclea r.In the present study,we discove red that the deletion of exon 2 of the Ctnnd2 gene was linked to social interaction deficits,spine loss,impaired inhibitory neurons,and suppressed phosphatidylinositol-3-kinase(PI3K)/protein kinase B(Akt) signal pathway in the prefrontal cortex.Our findings demonstrated that the long-term oral administration of melatonin for 28 days effectively alleviated the aforementioned abnormalities in Ctnnd2 gene-knockout mice.Furthermore,the administration of melatonin in the prefro ntal cortex was found to improve synaptic function and activate the PI3K/Akt signal pathway in this region.The pharmacological blockade of the PI3K/Akt signal pathway with a PI3K/Akt inhibitor,wo rtmannin,and melatonin receptor antagonists,luzindole and 4-phenyl-2-propionamidotetralin,prevented the melatonin-induced enhancement of GABAergic synaptic function.These findings suggest that melatonin treatment can ameliorate GABAe rgic synaptic function by activating the PI3K/Akt signal pathway,which may contribute to the improvement of dendritic spine abnormalities in autism spectrum disorders.

Melatonin and dopamine alleviate waterlogging stress in apples by recruiting beneficial endophytes to enhance physiological resilience

Melatonin and dopamine can potentially prevent waterlogging stress in apples.The current study investigated the mechanism by which melatonin and dopamine alleviate apple waterlogging stress.This study demonstrated that melatonin and dopamine alleviated waterlogging by removing reactive oxygen species(ROS),and that the nitric oxide(NO)content and nitrate reductase(NR)activity were significantly correlated.Melatonin and dopamine were also found to recruit different candidate beneficial endophytes(melatonin:Novosphingobium,Propionivibrio,and Cellvibrio;dopamine:Hydrogenophaga,Simplicispira,Methyloversatilis,Candidatus_Kaiserbacteria,and Humicola),and these endophytes were significantly and positively correlated with plant growth.Network analyses showed that melatonin and dopamine significantly affected the endophytic bacterial and fungal communities under waterlogging stress.The metabolomic results showed that melatonin and dopamine led to waterlogging resistance by upregulating the abundance of beneficial substances such as amino acids,flavonoids,coumarins,and organic acids.In addition,melatonin and dopamine regulated the physicochemical properties of the soil,which altered the endophyte community and affected plant growth.The co-occurrence network demonstrated close and complex relationships among endophytes,metabolites,soil,and the plants.Our results demonstrate that melatonin and dopamine alleviate waterlogging stress in apples by recruiting beneficial endophytes to enhance physiological resilience.This study provides new insights into how melatonin and dopamine alleviate stress and a theoretical basis for synergistic beneficial microbial resistance to waterlogging stress.

Melatonin delays leaf senescence in pak choi(Brassica rapa subsp.chinensis)by regulating biosynthesis of the second messenger cGMP

Melatonin(MT)is a low molecular weight compound with multiple biological functions in plants.It is known to delay leaf senescence in various species.However,no data are available on the MT signaling pathway in postharvest vegetables.This study demonstrates that MT increases cGMP concentration and the expression of the cGMP synthesis gene BcGC1 in pak choi.The c GMP inhibitor LY83583 destroys effect of MT delaying the leaf senescence.LY83583 also prevents MT treatment from reducing the expression of chlorophyll metabolism-related genes(BcNYC1,BcNOL,BcPPH1/2,BcSGR1/2,and BcPAO)and senescence genes(BcSAG12 and BcSAG21).It also inhibits MT from reducing the activity of the key chlorophyll catabolism enzymes Mg-dechelatase,pheophytinase,and pheide a oxygenase.Thus,the ability of MT to maintain high levels of chlorophyll metabolites is also destroyed.The Arabidopsis c GMP synthetic gene mutant atgc1 was used to confirm that delayed leaf senescence caused by MT is mediated,at least in part,by the second messenger c GMP.

Melatonin mitigates cold-induced damage to pepper seedlings by promoting redox homeostasis and regulating antioxidant profiling

This study assessed the influence of exogenous ME in the mitigation of cold damage in pepper seedlings. Melatonin(ME) is a dynamic molecule that helps plants cope with stress in several ways. Cold stress(CS) is one of the most important environmental factors that restrict plant growth and yield. Pepper(Capsicum annuum L.) is a valuable commercial crop, highly sensitive to CS. Thus, identifying an efficient strategy to mitigate cold damage is critical for long-term pepper production. For this purpose, the roots of pepper seedlings were pretreated with ME(5 μmol · L^(-1)) and exposed to CS for 7 d. The results indicated that CS suppressed pepper growth, hampered photosynthetic capacity, and damaged root architecture in pepper plants. In contrast, the production of reactive oxygen species(ROS), malondialdehyde(MDA), electrolyte leakage(EL), proline, and soluble sugars were enhanced in plants under CS. ME(5 μmol · L^(-1)) pretreatment reduced the negative effects of CS by recovering plant growth, root traits, gas exchange elements, and pigment molecules compared to CS control treatment. Furthermore, ME application efficiently reduced oxidative stress markers [hydrogen peroxide(H_(2)O_(2)), superoxide ion(O_(2)^(·-)), EL, and MDA] while increasing proline and soluble sugar content in pepper leaves. ME application combined with CS further increased antioxidant enzymes and related gene expression. Collectively, our results confirmed the mitigating potential of ME supplementation for CS by maintaining pepper seedling growth,improving the photosynthesis apparatus, regulating pigments, and osmolyte content.

Rice melatonin deficiency causes premature leaf senescence via DNA methylation regulation

In a study of DNA methylation changes in melatonin-deficient rice mutants,mutant plants showed premature leaf senescence during grain-filling and reduced grain yield.Melatonin deficiency led to transcriptional reprogramming,especially of genes involved in chlorophyll and carbon metabolism,redox regulation,and transcriptional regulation,during dark-induced leaf senescence.Hypomethylation of mCG and mCHG in the melatonin-deficient rice mutants was associated with the expression change of both protein-coding genes and transposable element-related genes.Changes in gene expression and DNA methylation in the melatonin-deficient mutants were compensated by exogenous application of melatonin.A decreased S-adenosyl-L-methionine level may have contributed to the DNA methylation variations in rice mutants of melatonin deficiency under dark conditions.

UV-B irradiation enhances the accumulation of beneficial glucosinolates induced by melatonin in Chinese kale sprout

Cruciferous sprout is a new form of vegetable product rich in bioactive compounds,especially glucosinolates.Previous studies have focused on increasing the accumulation of glucosinolates in cruciferous sprouts by applying different chemical regulators,with a particular focus on their contribution to nutritional quality and health benefits.Nevertheless,the effects of melatonin and UV-B irradiation on glucosinolate biosynthesis remain unclear.In this study,it was found that changes in melatonin concentrations significantly affected the contents of individual as well as total aliphatic and indolic glucosinolates.The 5μmol·L^(-1)melatonin was decided as the optimum concentration that could increase the content of beneficial glucosinolates including glucoraphanin and 4-methoxy glucobrassicin in Chinese kale sprouts.Notably,the enhancement of glucosinolate accumulation by melatonin treatment could be further amplified by UV-B irradiation.Furthermore,our results showed that R2R3-MYB transcription factor BoaMYB28 and BoaMYB51,which are central regulators of aliphatic and indolic glucosinolate biosynthesis respectively,were both involved in the regulation of glucosinolate biosynthesis by melatonin and UV-B irradiation.Additionally,the expression of glucosinolate biosynthetic genes,including BoaCYP79F1,BoaCYP83A1,BoaSUR1,BoaUGT74B1,BoaCYP79B2,BoaCYP79B3,and BoaCYP83B1 participated in the formation of core structures and BoaFMOGS-OX5,BoaAOP2,BoaCYP81F2,and BoaIGMT1 involved in the sidechain modification of aliphatic and indolic glucosinolate,was regulated by melatonin or UV-B irradiation.Taken together,these findings provide a potential strategy for improving the nutritional quality and resistance of Chinese kale sprouts.

Melatonin Alleviates Abscisic Acid Deficiency Inhibition on Photosynthesis and Antioxidant Systems in Rice under Salt Stress

Melatonin and abscisic acid,as major plant hormones,play important roles in the physiological and biochemical activities of crops,but the interaction between the two under salt stress is not yet clear.This study investigated the endogenous levels of melatonin and abscisic acid in rice by using exogenous melatonin,abscisic acid,and their synthetic inhibitors,and examined their interactions under salt stress.The research results indicate that melatonin and abscisic acid can improve rice salt tolerance.Melatonin alleviated the salt sensitivity caused by abscisic acid deficiency,increased antioxidant enzyme activity and antioxidant content in rice treated with abscisic acid synth-esis inhibitors,and reduced total reactive oxygen species content and thiobarbituric acid reactive substance accu-mulation.Melatonin also increased the activity of key photosynthetic enzymes and the content of photosynthetic pigments,maintaining the parameters of photosynthetic gas exchange and chlorophyllfluorescence.In summary,melatonin alleviated the effects of abscisic acid deficiency on photosynthesis and antioxidant systems in rice and improved salt tolerance.This study is beneficial for expanding the understanding of melatonin regulation of crop salt tolerance.

Butorphanol in epidural:Could this be the breakthrough solution for safe and effective labor analgesia that we've been waiting for?

The authors have conducted a comprehensive investigation into the safety and effectiveness of butorphanol for epidural analgesia during labor.Their critical analysis of the paper and discussion of the technique's advantages and disadvantages provide a thorough understanding of the topic.

Effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section

BACKGROUND Following cesarean section,a significant number of women encounter moderate to severe pain.Inadequate management of acute pain post-cesarean section can have far-reaching implications,adversely impacting maternal emotional wellbeing,daily activities,breastfeeding,and neonatal care.It may also impede maternal organ function recovery,leading to escalated opioid usage,heightened risk of postpartum depression,and the development of chronic postoperative pain.Both the Chinese Enhanced Recovery After Surgery(ERAS)guidelines and the American ERAS Society guidelines consistently advocate for the adoption of multimodal analgesia protocols in post-cesarean section pain management.Esketamine,functioning as an antagonist of the N-Methyl-D-Aspartate receptor,has been validated for pain management in surgical patients and has exhibited effectiveness in depression treatment.Research has suggested that incorporating esketamine into postoperative pain management via pain pumps can lead to improvements in short-term depression and pain outcomes.This study aims to assess the efficacy and safety of administering a single dose of esketamine during cesarean section.AIM To investigate the effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section.METHODS A total of 315 women undergoing elective cesarean section under combined spinal-epidural anesthesia were randomized into three groups:low-dose esketamine(0.15 mg/kg),high-dose esketamine(0.25 mg/kg),and control(saline).Postoperative Visual Analog Scale(VAS)scores were recorded at 6 hours,12 hours,24 hours,and 48 hours.Edinburgh Postnatal Depression Scale(EPDS)scores were noted on 2 days,7 days and 42 days.Ramsay sedation scores were assessed at specified intervals post-injection.Postoperative adverse reactions were also recorded.RESULTS Low-dose group and high-dose group compared to control group,had significantly lower postoperative VAS pain scores at 6 hours 12 hours,and 24 hours(P<0.05),with reduced analgesic usage(P<0.05).EPDS scores and postpartum depression rates were significantly lower on 2 days and 7 days(P<0.05).No significant differences in first exhaust and defecation times were observed(P>0.05),but ambulation times were shorter(P<0.05).Ramsay scores were higher at 5 minutes,15 minutes,and upon room exit(P<0.05).Low-dose group and high-dose group had higher incidences of hallucination,lethargy,and diplopia within 2 hours(P<0.05),and with low-dose group had lower incidences of hallucination,lethargy,and diplopia than high-dose group(P<0.05).CONCLUSION Esketamine enhances analgesia and postpartum recovery;a 0.15 mg/kg dose is optimal for cesarean sections,balancing efficacy with minimized adverse effects.

Effect of different anesthetic modalities with multimodal analgesia on postoperative pain level in colorectal tumor patients

BACKGROUND According to clinical data,a significant percentage of patients experience pain after surgery,highlighting the importance of alleviating postoperative pain.The current approach involves intravenous self-control analgesia,often utilizing opioid analgesics such as morphine,sufentanil,and fentanyl.Surgery for colo-rectal cancer typically involves general anesthesia.Therefore,optimizing anes-thetic management and postoperative analgesic programs can effectively reduce perioperative stress and enhance postoperative recovery.The study aims to analyze the impact of different anesthesia modalities with multimodal analgesia on patients'postoperative pain.AIM To explore the effects of different anesthesia methods coupled with multi-mode analgesia on postoperative pain in patients with colorectal cancer.METHODS Following the inclusion criteria and exclusion criteria,a total of 126 patients with colorectal cancer admitted to our hospital from January 2020 to December 2022 were included,of which 63 received general anesthesia coupled with multi-mode labor pain and were set as the control group,and 63 received general anesthesia associated with epidural anesthesia coupled with multi-mode labor pain and were set as the research group.After data collection,the effects of postoperative analgesia,sedation,and recovery were compared.RESULTS Compared to the control group,the research group had shorter recovery times for orientation,extubation,eye-opening,and spontaneous respiration(P<0.05).The research group also showed lower Visual analog scale scores at 24 h and 48 h,higher Ramany scores at 6 h and 12 h,and improved cognitive function at 24 h,48 h,and 72 h(P<0.05).Additionally,interleukin-6 and interleukin-10 levels were significantly reduced at various time points in the research group compared to the control group(P<0.05).Levels of CD3+,CD4+,and CD4+/CD8+were also lower in the research group at multiple time points(P<0.05).CONCLUSION For patients with colorectal cancer,general anesthesia coupled with epidural anesthesia and multi-mode analgesia can achieve better postoperative analgesia and sedation effects,promote postoperative rehabilitation of patients,improve inflammatory stress and immune status,and have higher safety.

Spinal Analgesia with Intrathecal Morphine versus Conventional Analgesia after Laparoscopic Colectomy: A Retrospective Cohort Study

Objective: Postoperative pain (POP) following abdominal surgery can vary from a few hours to several days. This acute, unrelieved pain can become chronic, requiring patients to take analgesics on an almost daily basis for comfort. Analgesia using general opioids has many side effects and intrathecal morphine is a good alternative. This study was conducted to evaluate the efficacy of intrathecal morphine (ITM) versus conventional analgesia in the management of postoperative pain in colectomy performed by laparoscopic surgery. Methods: Cohort study conducted at the Hôpital Nord in Marseille, from 01 January to 31 July 2021 in patients aged at least 18 years undergoing anaesthesia for scheduled colectomy by laparoscopic surgery. The primary endpoint was postoperative pain intensity and the secondary endpoints were morphine consumption, treatment side effects and length of hospital stay. Statistical analysis was performed using XLSTAT software. Results: We included 193 patients: 131 in the control group (conventional analgesia) and 62 in the ITM group. We observed: a significant decrease in pain (assessed by numerical scale) in favour of the ITM group in the post-anaesthetic care room, i.e. 3 (±4) vs 1 (±2), p 0 and H2: 2 (±2) vs. 1 (±2);p Conclusion: These results suggest that intrathecal morphine (ITM) in laparoscopic colectomy provides effective postoperative analgesia with low morphine consumption, and a reduction in morphine side-effects compared with conventional analgesia.

Starch Orodispersible Film Loaded with Melatonin for Human Supplementation

An innovative pharmaceutical form for administering melatonin,based on starch orodispersiblefilm(ODF),was designed and prepared.The composition of the ODF included starch as the polymer matrix,the active drug melatonin,and a plasticizer.Melatonin,a natural hormone produced by the pineal gland in the brain,can be absorbed by passive diffusion across the mucous membrane,resulting in improved bioavailability when compared to conventional oral administration.This study shows a simple and efficient method for preparing melatonin-loaded orodispersiblefilms with a physically stable and commercially viable matrix,suitable for use in the pharmaceutical industry.Thefilms were prepared by treating the starch with microwave irradiation,followed by plasticization with glycerol,melatonin loading and drying by solvent casting.Mechanical tests showed thefilms’robustness,with a modulus of approximately 97 MPa,indicating good handling properties.Moisture uptake analysis showed fast water absorption,reaching about 150%within 2 min,indicating its fast oral disintegration potential.Disintegration tests in artificial saliva and dissolution studies indicated the release of the drug in min-utes,indicating the potential properties of thefilm for oral drug delivery.To the best of our knowledge,there is no melatonin ODF based on starch described in the literature.

Effectiveness and safety of electroacupuncture analgesia in controlling intraoperative pain and hemodynamics during total thyroidectomy:A randomized controlled trial

Objective:To evaluate the effectiveness and safety of electroacupuncture in conjunction with additional medications in providing analgesia and stabilizing hemodynamic parameters during total thyroidectomy.Methods:This randomized controlled trial included 100 patients who underwent a total thyroidectomy between October 2022 and October 2023 at the Vietnam National Hospital of Acupuncture.The patients were randomized into two groups.The electroacupuncture analgesia(EA)group received EA stimulation at five acupuncture points:Hegu(LI 4),Neiguan(PC 6),Shuitu(ST 10),Quepen(ST 12),and Yifeng(SJ 17),while the control group received a bilateral superficial cervical plexus block.Primary outcomes included the level of analgesia and perioperative vital signs in both groups.Additionally,pain thresholds and serum b-endorphin levels were measured before and after electroacupuncture in the EA group.Results:Complete analgesia(Level A)was attained in 86%and 76%of the patients in the EA and control groups,respectively,with no significant difference between the two groups(P=1.00).In the EA group,the mean pain threshold after receiving EA doubled(648.7(77.4)g/s vs.305.3(45.3)g/s,P<.001),and the mean serum b-endorphin level increased by approximately 13.5 pg/mL(P<.001).All patients remained hemodynamically stable throughout the surgery.Conclusion:EA,in conjunction with additional medications that stimulate five acupuncture points,LI 4,PC 6,ST 10,ST 12,and SJ 17,was well tolerated and effectively maintained a suitable level of analgesia and hemodynamic stability during total thyroidectomy.

Postoperative Analgesia and Cesarean Section under General Anesthesia: Multicenter Study

Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North Franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4th post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia techniques (nerve blocks), particularly in countries with low availability of morphine.

Application of dezocine patient-controlled epidural analgesia in postoperative analgesia in patients with total myomectomy

BACKGROUND Uterine fibroids are common benign gynecological conditions.Patients who experience excessive menstruation,anemia,and pressure symptoms should be administered medication,and severe cases require a total hysterectomy.This procedure is invasive and causes severe postoperative pain,which can affect the patient’s postoperative sleep quality and,thus,the recovery process.AIM To evaluate use of dezocine in patient-controlled epidural analgesia(PCEA)for postoperative pain management in patients undergoing total myomectomy.METHODS We selected 100 patients undergoing total abdominal hysterectomy for uterine fibroids and randomized them into two groups:A control group receiving 0.2%ropivacaine plus 0.06 mg/mL of morphine and an observation group receiving 0.2%ropivacaine plus 0.3 mg/mL of diazoxide in their PCEA.Outcomes assessed included pain levels,sedation,recovery indices,PCEA usage,stress factors,and sleep quality.RESULTS The observation group showed lower visual analog scale scores,shorter postoperative recovery indices,fewer mean PCEA compressions,lower cortisol and blood glucose levels,and better polysomnographic parameters compared to the control group(P<0.05).The cumulative incidence of adverse reactions was lower in the observation group than in the control group(P<0.05).CONCLUSION Dezocine PCEA can effectively control the pain associated with total myomectomy,reduce the negative impact of stress factors,and have less impact on patients’sleep,consequently resulting in fewer adverse effects.