2.4. Intervention protocols
SE
CAVITY
After the patients entered the operating room, a Datex-Ohmeda anesthesia monitor was connected to monitor the entropy index. The stateentropy (SE), reactionentropy (RE), and SPI values were monitored using a GE Healthcare monitor (Helsinki, Finland). Both groups received target-controlled infusion (TCI) of dexmedetomidine (Dex) 0.8 μg/kg/10 minutes, intravenous tropisetron 5 mg, and intramuscular penehyclidine hydrochloride 0.1 mg/kg. After sedation, “eye sign” (Fig. (A)“Eye sign” and (B) “baby sign”. SF = subcutaneous fat; LD = latissimus dorsi; ES = vertical ridge; SPI = serratus posteriori; EO = external oblique muscle; IO = internal oblique muscle; TA = transversus abdominis; QL = quadratus lumborum; PM = psoas major; TP = transverse process; VB = vertebral body; AC = abdominal cavity; N = needle indication; “eye sign” = SPI-eyebrow, QL—eyeball, The 3 layers of abdominal wall muscles—crow’s feet; “baby sign” = QL—infant head, PM—infant body, TP and VB—pillow and cradle.After testing the block level, the anesthesiologist on duty opened the sealed envelope marked 2 and decided whether to administer the OFA based on the block plane test results. Total intravenous anesthesia was used in both groups. Anesthesia was induced and maintained with TCI of propofol 3 to 3.5 μg/mL and intravenous rocuronium 0.6 mg/kg in group F, or with TCI of propofol 3 to 3.5 μg/mL and remifentanil (Yichang Humanwell Pharmaceutical Co. Ltd., Yichang, Hubei, China; approval number: H20030197; specification:1 mg) 2 to 4 ng/mL and intravenous rocuronium 0.6 mg/kg in group C. Then, the 2 groups were fitted with a laryngeal mask airway 3 to 5 according to body weight, and 0.3 mg/kg rocuronium was added intermittently according to the need of surgery to maintain the entropy index value of 40 to 65 and SPI value of 30 to 50.When blood pressure was low and the heart rate was slow, ephedrine and atropine were administered for symptomatic treatment. Patients in both groups received intravenous flurbiprofen axetil 50 mg during skin suturing, followed by patient-controlled intravenous analgesia with esketamine 0.015 mg/(kg·h) (total dose ≤ 50 mg) + flurbiprofen 200 mg + Dex 100μg + tropisetron 5 mg + 0.9%NS to 100 mL, 2 mL/h. Electrocardiography, BP, pulse oxygen saturation (SPO