The postoperative analgesia of retrolaminar block in patients undergoing surgery with general anesthesia: a systematic review.

INTRODUCTION: Postoperative pain has always been a difficult problem in anesthesia management. The neurological block technique has been used for postoperative analgesia management, but compared with the traditional block method, the effect of postoperative analgesia after layer block is still controversial, and a clear literature review is needed. This systematic review's goal was to investigate RLB's impact on postoperative analgesia. EVIDENCE ACQUISITION: The literature search was performed using the PubMed, Web of Science, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Patients aged 18 years who underwent retrolaminar block were considered eligible. The article must report the results of the original study related to postoperative analgesia. The characteristics of the study sample and evaluating the RLB for postoperative analgesia were extracted from each included article and concluded. EVIDENCE SYNTHESIS: Eleven randomized controlled trials (726 patients) were included. After summarizing the analysis of the results of RLB on changing postoperative analgesia indexes in different surgeries, we concluded that PVB is better used for postoperative analgesia compared with RLB. The analgesic effect of RLB provides advantages compared with EPSB, SCPB, etc. CONCLUSIONS: Based on the results of this review, RLB can be applied to thoracic surgery, abdominal surgery and parotid surgery, but its analgesic effect is not significant enough, and further research is needed in the future to provide stronger evidence for postoperative analgesia in surgical patients.

High homocysteine promotes telomere dysfunction and chromosomal instability in human neuroblastoma SH-SY5Y cells.

Telomeres, specialized structures at the ends of linear chromosomes, protect chromosome ends from degradation, recombination, and mis-repair. Critically short telomere length (TL) may result in chromosome instability (CIN), causing tumor promotion and, at higher levels, cell death and tumor suppression. Homocysteine (Hcy) is a sulfur-containing amino acid involved in one-carbon metabolism. Elevated plasma Hcy is a cancer risk factor. Human SH-SY5Y neuroblastoma cells were treated with pathophysiological concentrations of Hcy (15-120 µM) for 14 and 28 days. The cytokinesis-block micronucleus cytome assay was used to determine cytostasis (nuclear division index, NDI), cell death (apoptosis and necrosis), and CIN (micronuclei, nucleoplasmic bridges, and nuclear buds in binucleated cells). Quantitative PCR was used to measure TL and the expression of hTERT, the gene encoding the catalytic subunit of telomerase for TL elongation. The results showed that Hcy induced elongation of TL and fluctuating changes in expression of hTERT. TL elongation was associated with increased CIN. Hcy decreased the NDI and increased cell death. This study shows that there is cross-talk between Hcy and TL in tumor cells and supports the concept that high Hcy inhibits cell division and promotes the death of tumor cells by abnormal elongation of TL and elevation of CIN.