Combined lumbar muscle block and perioperative comprehensive patient-controlled intravenous analgesia with butorphanol in gynecological endoscopic surgery

BACKGROUND Laparoscopic surgery has become a common surgical approach for the clinical treatment of intra-abdominal lesions in recent years.We hypothesized that lumbar block with postoperative patient-controlled intravenous analgesia(PCIA)by butorphanol after gynecological surgery under general anesthesia would be more effective than PCIA by butorphanol alone.AIM To investigate the effect of lumbar block with PCIA by butorphanol after gynecological surgery under general anesthesia.METHODS This study assessed 120 women scheduled for laparoscopic surgery at our hospital between May 2017 and May 2020.They were divided using a random number table into a research group(those who received quadratus lumborum block combined with PCIA analgesia by butorphanol)and a control group(those who received only PCIA analgesia by butorphanol),with 60 patients in each group.Demographic factors,visual analog scale scores for pain,serum inflammatory markers,PCIA compressions,Ramsay scores,and adverse events were compared between groups using a t-test,analysis of variance,orχ2 test,as appropriate.RESULTS There were no significant differences in demographic factors between groups(all P>0.05).The visual analog scale scores of the research group in the resting state 12 h and 24 h postoperatively were significantly lower than those of the control group(P<0.05).Two hours after surgery,there were no significant differences in the levels of serum tumor necrosis factor-α,interleukin(IL)-6,or IL-8 between groups(P>0.05).The serum tumor necrosis factor-αlevels of the research group 24 h postoperatively were significantly lower than those of the control group(P<0.05).The levels of serum IL-6 and IL-8 in the study group 24 h and 48 h postoperatively were significantly lower than those in the control group(P<0.05).CONCLUSION Lumbar block with PCIA with butorphanol after gynecological surgery under general anesthesia significantly improves the analgesic effect and reduces the degree of inflammation,instances of PCIA compression,and adverse reactions.

Effects of oxycodone and fentanyl patient-controlled intravenous analgesia on pain, immune response and stress response after laparoscopic surgery

Objective:To study the effects of oxycodone and fentanyl patient-controlled intravenous analgesia on pain, immune response and stress response after laparoscopic surgery.Methods:Patients undergoing laparoscopic surgery in Xianning Central Hospital between June 2015 and February 2017 were selected and randomly divided into oxycodone group and fentanyl group who received postoperative oxycodone and fentanyl patient-controlled intravenous analgesia respectively. 3 d after surgery and 5 d after surgery, the serum contents of pain-related transmitters, immune indexes, stress-related molecules as well as peripheral blood contents of immune cells were measured.Results: 3 d after surgery and 5 d after surgery, CRP, TNF-α, IL-8, sICAM-1, YKL-40, Cor, C-P, FT3, FT4 and HO-1 contents in serum of oxycodone group were significantly lower than those of fentanyl group whereas CD3+CD4+T cell and CD3+CD8+T cell contents in peripheral blood as well as C3 and C4 contents in serum were significantly higher than those of fentanyl group.Conclusion:oxycodone patient-controlled intravenous analgesia after laparoscopic surgery is better than fentanyl and can reduce the pain degree, inhibit the stress response and improve the immune response.

Effect of buprenorphine transdermal patch combined with patient-controlled intravenous analgesia on the serum pain-related biochemical indexes in elderly patients with intertrochanteric fracture

Objective:To study the effect of buprenorphine transdermal patch combined with patient-controlled intravenous analgesia on the serum pain-related biochemical indexes in elderly patients with intertrochanteric fracture.Methods: A total of 92 elderly patients with intertrochanteric fracture who received surgical treatment in the hospital between August 2014 and January 2017 were collected and divided into control group (n=46) and observation group (n=46) according to the random number table method. The control group received patient-controlled intravenous analgesia, and the observation group received buprenorphine transdermal patch combined with patient-controlled intravenous analgesia. Differences in serum levels of inflammatory factors, oxidative stress indexes and pain mediators of two groups of patients were measured before and 24h after surgery.Results: Differences in serum levels of inflammatory factors, oxidative stress indexes and pain mediators were not statistically significant between the two groups before surgery;24 h after surgery, serum IL-1β, IL-6, IL-8, TNF-α, MDA, SP, PGE2, 5-HT, HA and NPY levels of both groups of patients increased significantly while SOD, TAC and CAT levels decreased significantly, and serum IL-1β, IL-6, IL-8, TNF-α, MDA, SP, PGE2, 5-HT, HA and NPY levels of observation group were lower than those of control group while SOD, TAC and CAT levels were higher than those of control group.Conclusion: Buprenorphine transdermal patch combined with patient-controlled intravenous analgesia can effectively inhibit the expression of pain-related indexes and relieve early postoperative pain intensity in elderly patients with intertrochanteric fracture.

Patient-controlled intravenous fentanyl for cystospasm after transurethral resection of the prostate

Objective: To evaluate the clinical efficacy and safety of patient-controlled intravenous analgesia (PCIA) with fentanyl for cystospasm after transurethral resection of the prostate. Methods: Sixty benign prostatic hyperplasia (BPH) patients scheduled for transurethral resection of the prostate (TURP) under general anesthesia with laryngeal mask airway (LMA) were randomly divided into groups F and S. Group F (n=30) received PCIA device with fentanyl 10 μg/kg+8 mg ondansetron, and Group S (n=30) received placebo (PCIA device with 8 mg ondansetron). The visual analog scale (VAS) scores for pain were evaluated at 0, 2, 4, 8, 16, 24, and 48 h by the same staff. And recorded were incidence of cystospasm, side effects, application of hemostatic, duration of drawing Foley catheter and continuous bladder irrigation, time of exhaust after operation, time of post-operative stay and cost of hospitalization. Results: The incidence of cystospasm in Group F was significantly lower than that in Group S in the 48 h after operation (P<0.05), the VAS scores for pain in Group F was significantly lower than that in Group S within the 48 h after operation (P<0.01). The time of exhaust after operation in Group F was significantly later than in Group S (P<0.05). No significant difference was observed in applications of hemostatic, duration of drawing Foley catheter, duration of continuous bladder irrigation, time of post-operative stay and cost of hospitalization between the 2 groups. Conclusion: PCIA with fentanyl (10 μg/kg) relieves pain with little side effect and reduces cystospasm satisfactorily.

Total Intravenous Anesthesia (TIVA) for Stiff-Person Syndrome

Stiff-Person syndrome is a rare autoimmune neurologic disorder that affects the central nervous system by inhibiting production of the neurotransmitter gamma-aminobutyric acid. Painful muscle spasms and rigidity are the clinical manifestations of the disease. An ideal anesthetic technique has not been described for this patient population because of the rarity of the disease. This case report describes the successful use of total intravenous anesthesia in a patient with Stiff- Person Syndrome.

Effects of Total Intravenous Anesthesia and Static Aspiration Combined General Anesthesia on Postoperative Cognitive Function and Psychological State of Elderly Patients with Esophageal Cancer

Objective: To compare the effects of total intravenous anesthesia and static aspiration combined general anesthesia on postoperative cognitive function and psychological state of elderly esophageal cancer patients. Methods: From July 2020 to April 2021, 180 elderly patients who underwent radical esophageal cancer surgery in our hospital were randomly divided into 90 cases in the control group and 90 in the observation group. The control group used static aspiration compound general anesthesia, and the patients in the observation group used intravenous anesthesia to compare the cognitive function and psychological state of the two groups of patients. Results: There was no statistical difference in the cognitive function score of patients in the observation group 30 minutes before anesthesia, 1 h and 24 hours after anesthesia compared with that in the control group, P > 0.05;there was no statistical difference between the Hamilton Anxiety Scale (HAMA) scores 30 minutes before and 24 hours after anesthesia in the observation group compared with the control group, P > 0.05;the cognitive function score of patients in the observation group of 4 h after surgery and 12 h after operation was significantly higher than that of the control group;the HAMA scores of patients in the observation group of 1 h, 4 h and 12 h after surgery were significantly lower than that of the control group, P Conclusion: The application of total intravenous anesthesia in elderly patients with esophageal cancer surgery can reduce the impact of anesthesia on their cognitive function and psychological state, which is worth popularizing and applying in clinical practice.

Oral Glucose Combined with Short-Term Intravenous Nutrition for the Prevention of Hypoglycemia after Painless Endoscopic Gastric Polypectomy

Objective: To explore the application effect of oral glucose combined with short-term intravenous nutrition in preventing postoperative hypoglycemia after painless endoscopic gastric polyp resection, and to provide guidance for better management of patients undergoing such procedures. Methods: A total of 886 patients who underwent painless endoscopic gastric polyp resection in the Department of Gastroenterology, the First Affiliated Hospital of Yangtze University, from January 2020 to December 2021, were selected as the study subjects. According to the random number table method, they were divided into an experimental group and a control group, with 443 cases in each group. Patients in the control group were subjected to routine fasting and water restriction for 8 hours before surgery, and routine fasting for 24 hours after surgery. Short-term intravenous nutrition support was provided through fluid supplementation, and finger blood glucose levels were monitored at 1 hour, 4 hours, and 8 hours after completion of intravenous infusion, or when symptoms such as palpitations and cold sweats occurred. The experimental group received oral administration of 5% glucose solution (500 ml) 2 hours before surgery based on the procedures of the control group. The incidence of preoperative discomfort (hunger, thirst, and fatigue), residual gastric fluid volume, and postoperative hypoglycemia were compared between the two groups. Results: The incidence of postoperative blood glucose Conclusion: Based on the study population, oral glucose combined with short-term intravenous nutrition can effectively prevent the incidence of hypoglycemia in patients undergoing painless endoscopic gastric polyp resection. However, due to the limitations of a single-center study and a small number of cases, its feasibility needs to be further validated with more data from multi-center and large-sample cases.

Effect of epidural block combined intravenous general anesthesia stress on the stress response and T lymphocyte subsets in patients with breast cancer undergoing radical mastectomy

Objective: To investigate the effect of epidural block combined with intravenous anesthesia on stress response and T lymphocyte subsets in patients with breast cancer undergoing radical mastectomy. Methods: In our hospital from July 2016 to June 2017 undergoing radical mastectomy for breast cancer of 88 patients were randomly divided into observation group and control group of 44 cases, 2 patients underwent routine preoperative preparation, and routine blood pressure, heart rate, pulse, oxygen saturation, ECG monitoring, control group with intravenous anesthesia. The observation group was treated with epidural block combined with intravenous anesthesia. 2 groups of patients before anesthesia, 30 MIM (T0), 1 h after skin incision (T1), 4 h after operation (T2), 24 h after operation (T3), 48 h after operation (T4) from peripheral venous blood were measured by interleukin-8 (IL-8) and interferon gamma (IFN-γ), cortisol (Cor), prolactin (PRL), growth hormone (GH) and T lymphocyte subsets (CD3+, CD4+, CD8+), the calculation of CD4+/CD8+ value. Results: the serum IL-8 level of T1, T2, T3and T4 decreased gradually, were lower than at T0, and the control group at each time point had no significant difference, T1, T2, T3group, T4IL-8 levels lower than the control group;the 2 groups of serum IFN-γ levels T1 and T2had no significant change, T3and T4increased gradually, was higher than that of T0, but no significant difference between the 2 groups of IFN-γ levels. 2 serum Cor levels peaked at T1, decreased at T2, was higher than that of T0, T3, T4returned to T0, the observation group T1, T2Cor level lower than the control group;the serum PRL levels of 2 groups reached a peak at T1, T2, T3at the time of T4decreased gradually, was higher than that of T0, T1, T2, T3of the observation group at the PRL level is lower than the control group;the serum level of GH 2 in group T1increased gradually, reached a peak at T2, T3and T4 decreased gradually, was higher than that of T0, the observation group T1, T2, T3, T4, GH levels lower than the control group. 2 groups of CD3+ decreased gradually in T1, T2, were lower than T0, T3, T4returned to T0, the observation group T1, T2CD3+ was higher than the control group;group CD4+ decreased gradually in T1, T2, T3and T4were lower than control, T0when, and the observation group CD4+ in T1, T2, T3, T4, no significant changes were observed in group T1, T2, T3, T4and CD4+ higher than that of the control group;the 2 group CD8+ had no obvious changes in T1, T2, T3, T4;observation group CD4+/CD8+ decreased gradually in T1, T2, were lower than T0, T3, T4returned to T0, the observation group T1, T2CD4+/CD8+ was higher than the control group. Conclusion: epidural block combined with intravenous anesthesia for breast cancer radical mastectomy can effectively relieve the stress and inflammatory reaction, alleviate the immunosuppression, and help to restore the postoperative immune function.

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.

Safety and Efficacy of Pediatric General Anesthesia by Laryngeal Mask Airway Without Intravenous Access

The safety and efficacy of the laryngeal mask airway (LMA) has been reported by numerous large-scale studies. However, they do not address the issue of whether an intravenous (IV) is required for pediatric general anesthesia (GA) where access is challenging due to anatomical considerations and a lack of cooperation. The aims of this study are to determine whether pediatric GA by LMA without IV access affected placement rates, procedure times and rates of anesthetic complications. Children who met these criteria at the UIC Surgicenter in the two year period prior to August 30, 2005 were selected. A retrospective chart review was conducted to determine patient demographics, ASA class, procedure, placement success, IV placed if any, time to incision, and any anesthetic complications. 241 patients without IV access and 41 patients with IV access were included. No significant differences were found between the groups in the rates of LMA placement or anesthetic complications. Significant differences were found in times to incision overall and for ophthalmology exams under anesthesia and lacrimal duct probings. Pediatric GA by LMA without IV access demonstrated a similarly high placement rate, shorter procedure times and a low rate of complications in comparison with the control group.

Uncontrolled high blood pressure under total intravenous anesthesia with propofol and remifentanil:A case report

BACKGROUND Although propofol generally reduces blood pressure,rarely,it causes hypertension.However,the mechanism by which propofol increases blood pressure has not been established,and so far,there are only a few reported cases.CASE SUMMARY A 46-year-old woman,diagnosed with thyroid cancer,was administered general anesthesia with propofol and remifentanil for a thyroid lobectomy.An increase in the concentrations of intravenous anesthetics further increased her blood pressure.The blood pressure remained stable when anesthesia was maintained with sevoflurane and remifentanil after the interruption of propofol administration.CONCLUSION We concluded that propofol administration was the cause of increased blood pressure.

A COMPARISON OF THE EFFECTS OF THE PROPOFOL VERSUS MIDAZOLAM DURING TOTAL INTRAVENOUS ANESTHESIA FOR GYNECOLOGICAL SURGERY PR

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Effect of propofol intravenous anesthesia on hemorheology, hemodynamics and immune function in patients with colorectal cancer after radical operation

Objective:To investigate the effect of Propofol Intravenous Anesthesia on hemorheology, hemodynamics and immune function in patients with colorectal cancer after radical operation.Method: A total of 100 patients with colorectal cancer treated in our hospital from September 2015 to August 2017 were randomly divided into observation group and control group according to random number table. The control group was inhaled sevoflurane anesthesia, observation group propofol intravenous anesthesia. The changes of hemorheology, hemodynamics and immune function were compared between the two groups.Results: There was no significant difference in hemorheology index, hemodynamic index, T lymphocyte subsets CD45RA+, CD45RO+, CD45RA+/CD45RO+ levels between the two groups before anesthesia. Anesthesia 1.5 h after, the levels of LBV, HBV, PV, EAI and EDI in the two groups were significantly decreased, but there was no significant difference between the observation group and the control group. At 1.5 h after anesthesia induction, the HR and SBP levels of the observation group did not change significantly compared with anesthesia before, while the HR and SBP levels of the 1.5 h after anesthesia induction in the control group were significantly lower than those before anesthesia and significantly lower than the corresponding level HR level (86.43±13.25) times/min, SBP level (110.84±15.41) mmHg in the observation group. At the end of surgery, the levels of CD45RA+ and CD45RO+ in the observation group were significantly decreased, but increased at 72 h after operation.Conclusion: After operation, CD45RA+ and CD45RO+ levels in the control group were significantly decreased, and preoperatively, which can significantly improve the hemorheology and reduced hemodynamic effects, and contribute to the recovery of patients with immune function, is worth clinical promotion.

Effect of epidural anesthesia combined with total intravenous anesthesia on stress response and coagulation function in and after laparoscopic surgery

Objective:To study the effect of epidural anesthesia combined with total intravenous anesthesia on stress response and coagulation function in and after laparoscopic surgery. Methods: A total of 219 cases of patients who underwent laparoscopic cholecystectomy in our hospital between August 2014 and February 2017 were collected and divided into control group (n=125) who accepted total intravenous anesthesia alone and observation group (n=94) who accepted epidural anesthesia combined with total intravenous anesthesia after the anesthesia scheme was reviewed. Perioperative stress response and coagulation function were compared between two groups of patients.Results: Before operation, differences in the serum stress index contents and peripheral blood coagulation index levels were not statistically significant between two groups of patients. In operation and 2 h after operation, serum stress indexes Cor, Ang-Ⅰ, Ang-Ⅱ and NE contents of observation group were significantly lower than those of control group;peripheral blood coagulation indexes PT, TT and APTT levels were significantly higher than those of control group while TXA2, TXB2 and FBG levels were significantly lower than those of control group.Conclusions: Epidural anesthesia combined with total intravenous anesthesia can effectively alleviate the systemic stress response and reduce the hypercoagulable state in and early after laparoscopic surgery.

Effect of intravenous inhalational anesthesia under Narcotrend monitor on the systemic traumatic reaction after laparoscopic cholecystectomy

Objective:To study the effect of intravenous inhalational anesthesia under Narcotrend monitor on the systemic traumatic reaction after laparoscopic cholecystectomy.Methods:A total of 116 patients with gallstone who received laparoscopic surgery in our hospital between July 2012 and April 2016 were collected and divided into the combined anesthesia group (n=65) who accepted intravenous inhalational anesthesia under Narcotrend monitor and the intravenous anesthesia group (n=51) who accepted total intravenous anesthesia after the anesthesia methods and relevant test results were reviewed. 1 d after operation, enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of pain mediators and inflammation mediators;automatic biochemical analyzer was used to detect the levels of oxidative stress indexes.Results:1 d after operation, serum pain mediators 5-HT, PGE2, NO and HT levels of observation group were lower than those of control group;serum oxidation indexes AOPPs and LHP levels of observation group were lower than those of control group while anti-oxidation indexes CAT and GSH-Px levels were higher than those of control group;serum pro-inflammatory factors IL-6, IL-8 and CRP levels of observation group were lower than those of control group while anti-inflammatory factors IL-4, IL-10 and IL-13 levels were higher than those of control group.Conclusion:Intravenous inhalational anesthesia under Narcotrend monitor can reduce the postoperative systemic traumatic reaction degree in patients with laparoscopic cholecystectomy.

Differences in the effects of intravenous inhalational anesthesia and total intravenous anesthesia on the systemic traumatic response after laparoscopic cholecystectomy

Objective: To study the effect of intravenous inhalational anesthesia under monitoring on systemic traumatic response after laparoscopic cholecystectomy. Methods: A total of 80 cases of patients with chronic cholecystitis who received laparoscopic cholecystectomy in our hospital between June 2016 and October 2016 were collected and divided into the control group who accepted total intravenous anesthesia and the observation group who accepted intravenous inhalational anesthesia after the anesthesia methods were reviewed. 6 h, 12 h and 24 h after operation, the RIA method was adopted to determine the serum contents of pain mediators, enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of inflammatory factors and stress hormones, and auto-coagulation analyzer was used to detect the plasma contents of coagulation function indexes. Results: 6 h, 12 h and 24 h after operation, serum pain mediators 5-HT, β-EP and NPY levels of observation group were lower than those of control group, inflammatory factors hs-CRP, IL-6, IL-8 and TNF-α levels were lower than those of control group, and stress hormones Cor, ALD and NE levels were lower than those of control group;plasma coagulation function indexes TXB2, D-D and PLT levels of observation group were lower than those of control group. Conclusion: Intravenous inhalational anesthesia under monitoring can reduce the systemic traumatic reaction after laparoscopic cholecystectomy and has positive clinical significance.

Effects of intravenous inhalational anesthesia on the hemodynamic homeostasis as well as postoperative brain function and Th1/Th2 immunity in elderly patients with femoral neck fracture

Objective: To explore the effects of intravenous inhalational anesthesia on the hemodynamic homeostasis as well as postoperative brain function and Th1/Th2 immunity in elderly patients with femoral neck fracture. Methods: A total of 176 elderly patients with femoral neck fracture who received hip replacement in our hospital between July 2016 and June 2017 were divided into the total intravenous anesthesia group (n=86) and the intravenous inhalational anesthesia group (n=90) according to the anesthesia solution. The differences in introperative hemodynamic parameter levels as well as postoperative brain function index and Th1/Th2 cytokine contents were compared between the two groups. Results: During operation, hemodynamic parameters MAP and HR levels in intravenous inhalational anesthesia group were lower than those in total intravenous anesthesia group. 24 h after operation, serum brain function indexes MBP, S100B and NSE contents in intravenous inhalational anesthesia group were lower than those in total intravenous anesthesia group;serum Th1 cytokines IFN-γand IL-2 contents were higher than those in total intravenous anaesthesia group whereas Th2 cytokines IL-4 and IL-13 contents were lower than those in total intravenous anesthesia group. Conclusion: The intravenous inhalational anesthesia can effectively stabilize the intraoperative hemodynamics and reduce the postoperative brain function and Th1/Th2 immune function injury in elderly patients with femoral neck fracture.

Comparison of oxycodone and sufentanil in patient-controlled intravenous analgesia for postoperative patients:a meta-analysis of randomized controlled trials

Background:Managing acute postoperative pain is challenging for anesthesiologists,surgeons,and patients,leading to adverse events despite making significant progress.Patient-controlled intravenous analgesia(PCIA)is a recommended solution,where oxycodone has depicted unique advantages in recent years.However,controversy still exists in clinical practice and this study aimed to compare two drugs in PCIA.Methods:We performed a literature search in PubMed,Embase,the Cochrane Central Register of Controlled Trials,Web of Science,Chinese National Knowledge Infrastructure,Wanfang,and VIP databases up to December 2020 to select specific randomized controlled trials(RCTs)comparing the efficacy of oxycodone with sufentanil in PCIA.The analgesic effect was the primary outcome and the secondary outcome included PCIA consumption,the Ramsay sedation scale,patients’satisfaction and side effects.Results:Fifteen RCTs were included in the meta-analysis.Compared with sufentanil,oxycodone showed lower Numerical Rating Scale scores(mean difference[MD]=-0.71,95%confidence interval[CI]:-1.01 to-0.41;P<0.001;I^(2)=93%),demonstrated better relief from visceral pain(MD=-1.22,95%CI:-1.58 to-0.85;P<0.001;I^(2)=90%),promoted a deeper sedative level as confirmed by the Ramsay Score(MD=0.77,95%CI:0.35-1.19;P<0.001;I^(2)=97%),and resulted in fewer side effects(odds ratio[OR]=0.46,95%CI:0.35-0.60;P<0.001;I^(2)=11%).There was no statistical difference in the degree of patients'satisfaction(OR=1.13,95%CI:0.88-1.44;P=0.33;I^(2)=72%)and drug consumption(MD=-5.55,95%CI:-14.18 to 3.08;P=0.21;I^(2)=93%).Conclusion:Oxycodone improves postoperative analgesia and causes fewer adverse effects,and could be recommended for PCIA,especially after abdominal surgeries.Registration:PROSPERO;https://www.crd.york.ac.uk/PROSPERO/;CRD42021229973.

Method for Single Intravenous Anesthetic Infusion in a Rodent Model

Venous catheterization, endotracheal intubation, and mechanical ventilation are necessary for performing total intravenous general anesthesia in rats. Intubation and IV cannulation of the rat is challenging because of the animals’ small size and the lack of equipment specifically designed for the restricted anatomical dimensions. Here, we present methods for tail venous catheterization and intubation that are quickly learned by the provider with clinical operating room experience but lack experience in the lab. For tail venous catheterization, each rat (n = 20) was gently restrained in a rat chamber;its tail was placed in warm water for 10 minutes, and a 24 gauge intravenous catheter was inserted into the lateral tail vein. The catheter was fixed in place using tape and attached to a T-connector for drug administration. A bolus of propofol (n = 10), ketamine (n = 7), or etomidate (n = 3) was administered to achieve rapid deep anesthesia. Once anesthetized, rats were intubated with the aid of a modified pediatric laryngoscope. The standard miller blade 0 was cut on each side for approximately 2/3 of the total blade length to remove a total of half the width. After the ventilator was properly set, the rats’ vital signs and metabolic status were monitored. Throughout the one-hour infusion, the rats’ physiologic parameters were maintained within normal range. These results indicate that intravenous general anesthesia can be performed effectively and safely in small animals using the refined catheterization and intubation methods tested in this study. These techniques are easily reproducible and learned as they mimic the tools and strategies commonly used in the OR.