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\begin{document}

\title{Effects of general anesthesia and ultrasonography-guided interscalene
block on pain and oxidative stress in shoulder arthroscopy: a randomized
trial}



\author[1]{MURAT ÖKSÜZ}%
\author[2]{Suheyla Abitagaoglu}%
\author[3]{Ahmet Kaciroglu}%
\author[2]{Ceren Koksal}%
\author[2]{Burak Yagmur Ozturk}%
\author[4]{Özcan Erel}%
\author[4]{Almila Senat Aydin}%
\author[2]{Dilek Erdogan Ari}%
\affil[1]{Sancaktepe Şehit Prof Dr Ilhan Varank Training and Research Hospital}%
\affil[2]{Fatih Sultan Mehmet Training and Research Hospital}%
\affil[3]{Bursa City Hospital}%
\affil[4]{Ankara Yildirim Beyazit Universitesi Tip Fakultesi}%


\vspace{-1em}



  
  \date{June 17, 2024}


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\selectlanguage{english}
\begin{abstract}
Background/aim: The aim of this study was to evaluate the effects of
general anesthesia and ultrasonography-guided interscalene block on pain
and oxidative stress evaluated by thiol--disulphide balance and
C-reactive protein levels in patients undergoing shoulder arthroscopy.
Materials and methods: A total of 42 patients aged 18--75 years who were
scheduled to undergo shoulder arthroscopy were randomized into
interscalene block group (Group-IB, n = 20) and general anesthesia group
(Group-GA, n = 22). All patients received patient-controlled analgesia
during the postoperative period. Additional analgesics were administered
to patients with a visual analog scale score of \textgreater{} 4. Native
-thiol, total -thiol, disulphide and C-reactive protein levels were
measured. Patients' visual analog scale scores, morphine and additional
analgesic consumption were recorded. A shift in thiol--disulphide
balance toward decreased thiol and increased disulphide levels was
regarded as an indicator of oxidative stress. Results: Pain level,
morphine and additional analgesic consumption were higher in Group-GA.
Native-thiol and total-thiol levels were higher in Group-IB
postoperatively and also disulphide levels were lower at postoperative
18 hours. C-reactive protein levels were similar in both the groups.
Conclusion: Interscalene block induced less oxidative stress during the
postoperative period, as evaluated by thiol--disulphide balance.%
\end{abstract}%



\sloppy


\textbf{Acknowledgement/Disclaimers/Conflict of interest}

All authors have contributed to the paper, met criteria of authorship
and are familiar with the contents of the final draft.

No support has been received from any funding organization for this
research.

There is no conflict of interest with any financial organization.

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Table 1. Demographic Characteristics and Duration of Surgery\selectlanguage{english}
\begin{longtable}[]{@{}lllll@{}}
\toprule
& & Group IB (n = 20) & Group GA (n = 22) & p\tabularnewline
\midrule
\endhead
& & Median (minimum--maximum) or n (\%) & Median (minimum--maximum) or n
(\%) &\tabularnewline
Age (yr) & Age (yr) & 49.5 (18--66) & 48.5 (22--71) &
0.668\textsuperscript{a}\tabularnewline
Sex & Sex & & & 0.303\textsuperscript{b}\tabularnewline
& M/F & 6/14 & 10/12 &\tabularnewline
Height (cm) & Height (cm) & 1.64 (1.54--1.83) & 1.61 (1.5--1.8) &
0.578\textsuperscript{a}\tabularnewline
Body weight (kg) & Body weight (kg) & 71.5 (55--95) & 75.5 (53--95) &
0.632\textsuperscript{a}\tabularnewline
BMI (kg/m\textsuperscript{2}) & BMI (kg/m\textsuperscript{2}) & 27.95
(22--38.2) & 26.95 (20.3--35) & 0.687\textsuperscript{a}\tabularnewline
ASA score & ASA score & & & 0.768\textsuperscript{b}\tabularnewline
& I (\%) & 10 (50) & 10 (45.5) &\tabularnewline
& II (\%) & 10 (50) & 12 (54.5) &\tabularnewline
Presence of comorbid disease (\%) & Presence of comorbid disease (\%) &
9 (45) & 10 (45.5) & 0.976\textsuperscript{b}\tabularnewline
Duration of surgery (min) & Duration of surgery (min) & 47.5 (20--80) &
60 (15--150) & 0.139\textsuperscript{a}\tabularnewline
\bottomrule
\end{longtable}

\textsuperscript{a}Mann--Whitney U test, \textsuperscript{b}Chi-square
Test

Table 2. Amount of Total Morphine Consumed Through Patient-Controlled
Analgesia and Need for Additional Analgesics\selectlanguage{english}
\begin{longtable}[]{@{}lllllllll@{}}
\toprule
& & Group IB & Group IB & Group GA & Group GA & p & p & p\tabularnewline
\midrule
\endhead
Patient-controlled analgesia (mg) \emph{Median(minimum--maximum)} &
Patient-controlled analgesia (mg) \emph{Median(minimum--maximum)} & & &
& & & &\tabularnewline
Postoperative 0 minute & Postoperative 0 minute & 0 (0--0) & 0 (0--0) &
0 (0--1) & 0 (0--1) & 0.340\textsuperscript{a} &
0.340\textsuperscript{a} & 0.340\textsuperscript{a}\tabularnewline
Postoperative 30 minutes & Postoperative 30 minutes & 0 (0--0) & 0
(0--0) & 2 (1--2) & 2 (1--2) & \textless{}0.001\textsuperscript{a} &
\textless{}0.001\textsuperscript{a} &
\textless{}0.001\textsuperscript{a}\tabularnewline
Postoperative 3 hours & Postoperative 3 hours & 0 (0--0) & 0 (0--0) & 8
(4--10) & 8 (4--10) & \textless{}0.001\textsuperscript{a} &
\textless{}0.001\textsuperscript{a} &
\textless{}0.001\textsuperscript{a}\tabularnewline
Postoperative 6 hours & Postoperative 6 hours & 0 (0--0) & 0 (0--0) & 14
(7--18) & 14 (7--18) & \textless{}0.001\textsuperscript{a} &
\textless{}0.001\textsuperscript{a} &
\textless{}0.001\textsuperscript{a}\tabularnewline
Postoperative 18 hours & Postoperative 18 hours & 0 (0--0) & 0 (0--0) &
18 (11--26) & 18 (11--26) & \textless{}0.001\textsuperscript{a} &
\textless{}0.001\textsuperscript{a} &
\textless{}0.001\textsuperscript{a}\tabularnewline
Need for additional analgesics n (\%) & & & & & & & &\tabularnewline
Postoperative 0 minute & 0 (0) & 0 (0) & 22 (100) & 22 (100) &
\textless{}0.001\textsuperscript{b} &
\textless{}0.001\textsuperscript{b} &
\textless{}0.001\textsuperscript{b} &\tabularnewline
Postoperative 30 minute & 0 (0) & 0 (0) & 6 (27.3) & 6 (27.3) &
0.022\textsuperscript{b} & 0.022\textsuperscript{b} &
0.022\textsuperscript{b} &\tabularnewline
Postoperative 3 hours & 0 (0) & 0 (0) & 21 (95.5) & 21 (95.5) &
\textless{}0.001\textsuperscript{b} &
\textless{}0.001\textsuperscript{b} &
\textless{}0.001\textsuperscript{b} &\tabularnewline
Postoperative 6 hours & 0 (0) & 0 (0) & 11 (50) & 11 (50) &
\textless{}0.001\textsuperscript{b} &
\textless{}0.001\textsuperscript{b} &
\textless{}0.001\textsuperscript{b} &\tabularnewline
Postoperative 18 hours & 0 (0) & 0 (0) & 3 (13.6) & 3 (13.6) &
0.233\textsuperscript{b} & 0.233\textsuperscript{b} &
0.233\textsuperscript{b} &\tabularnewline
\textsuperscript{a}Mann--Whitney U test, \textsuperscript{b}Chi-square
test & \textsuperscript{a}Mann--Whitney U test,
\textsuperscript{b}Chi-square test & \textsuperscript{a}Mann--Whitney U
test, \textsuperscript{b}Chi-square test &
\textsuperscript{a}Mann--Whitney U test, \textsuperscript{b}Chi-square
test & \textsuperscript{a}Mann--Whitney U test,
\textsuperscript{b}Chi-square test & \textsuperscript{a}Mann--Whitney U
test, \textsuperscript{b}Chi-square test &
\textsuperscript{a}Mann--Whitney U test, \textsuperscript{b}Chi-square
test & \textsuperscript{a}Mann--Whitney U test,
\textsuperscript{b}Chi-square test &\tabularnewline
\bottomrule
\end{longtable}

Table 3. Levels of Native Thiol, Total Thiol, Disulphide and Ratio of
Disulphide/Native Thiol Level\selectlanguage{english}
\begin{longtable}[]{@{}llllllllllll@{}}
\toprule
& Group IB & Group IB & Group IB & Group GA & Group GA & Group GA &
Group GA & Group GA & Group GA & p & p\tabularnewline
\midrule
\endhead
& Median (minimum--maximum) & Median (minimum--maximum) & Median
(minimum--maximum) & Median (minimum--maximum) & Median
(minimum--maximum) & Median (minimum--maximum) & Median
(minimum--maximum) & Median (minimum--maximum) & Median
(minimum--maximum) & &\tabularnewline
Native thiol (\selectlanguage{greek}µ\selectlanguage{english}mol/L) & & & & & & & & & & &\tabularnewline
Baseline & 224.8 (69.6--293.4) & 224.8 (69.6--293.4) & 224.8
(69.6--293.4) & 181 (63.3--341.6) & 181 (63.3--341.6) & 181
(63.3--341.6) & 181 (63.3--341.6) & 181 (63.3--341.6) & 0.023* & 0.023*
& 0.023*\tabularnewline
Intraoperative 30 minutes & 220.2 (138.6--269.7) & 220.2 (138.6--269.7)
& 220.2 (138.6--269.7) & 187.5 (25.6--326.1) & 187.5 (25.6--326.1) &
187.5 (25.6--326.1) & 187.5 (25.6--326.1) & 187.5 (25.6--326.1) & 0.006*
& 0.006* & 0.006*\tabularnewline
Postoperative 3 hours & 209.5 (140.1--254.7) & 209.5 (140.1--254.7) &
209.5 (140.1--254.7) & 182.5 (84.6--299.8) & 182.5 (84.6--299.8) & 182.5
(84.6--299.8) & 182.5 (84.6--299.8) & 182.5 (84.6--299.8) & 0.268 &
0.268 & 0.268\tabularnewline
Postoperative 6 hours & 199.8 (151.2--281.3) & 199.8 (151.2--281.3) &
199.8 (151.2--281.3) & 173.2 (94.3--280.8) & 173.2 (94.3--280.8) & 173.2
(94.3--280.8) & 173.2 (94.3--280.8) & 173.2 (94.3--280.8) & 0.007* &
0.007* & 0.007*\tabularnewline
Postoperative 18 hours & 226.3 (43.1--268.5) & 226.3 (43.1--268.5) &
226.3 (43.1--268.5) & 168 (86.4--287.5) & 168 (86.4--287.5) & 168
(86.4--287.5) & 168 (86.4--287.5) & 168 (86.4--287.5) & 0.008* & 0.008*
& 0.008*\tabularnewline
Total thiol (\selectlanguage{greek}µ\selectlanguage{english}mol/L) & & & & & & & & & & &\tabularnewline
Baseline & 256.7 (83.2--329.9) & 256.7 (83.2--329.9) & 256.7
(83.2--329.9) & 200.5 (117.6--354.9) & 200.5 (117.6--354.9) & 200.5
(117.6--354.9) & 200.5 (117.6--354.9) & 200.5 (117.6--354.9) & 0.040* &
0.040* & 0.040*\tabularnewline
Intraoperative 30 minutes & 231 (145.6--296.7) & 231 (145.6--296.7) &
231 (145.6--296.7) & 199 (77.1--345.1)\textsuperscript{\#} & 199
(77.1--345.1)\textsuperscript{\#} & 199
(77.1--345.1)\textsuperscript{\#} & 199
(77.1--345.1)\textsuperscript{\#} & 199
(77.1--345.1)\textsuperscript{\#} & 0.015* & 0.015* &
0.015*\tabularnewline
Postoperative 3 hours & 221.5 (152.2--267.2)\textsuperscript{\&} & 221.5
(152.2--267.2)\textsuperscript{\&} & 221.5
(152.2--267.2)\textsuperscript{\&} & 197.9 (89.9--312.6) & 197.9
(89.9--312.6) & 197.9 (89.9--312.6) & 197.9 (89.9--312.6) & 197.9
(89.9--312.6) & 0.378 & 0.378 & 0.378\tabularnewline
Postoperative 6 hours & 229.3 (180.3--295.1)\textsuperscript{\&} & 229.3
(180.3--295.1)\textsuperscript{\&} & 229.3
(180.3--295.1)\textsuperscript{\&} & 189.9 (99.4--304.6) & 189.9
(99.4--304.6) & 189.9 (99.4--304.6) & 189.9 (99.4--304.6) & 189.9
(99.4--304.6) & 0.014* & 0.014* & 0.014*\tabularnewline
Postoperative 18 hours & 242.3 (52.8--405.2) & 242.3 (52.8--405.2) &
242.3 (52.8--405.2) & 198.6 (107.2--300.6)\textsuperscript{\&} & 198.6
(107.2--300.6)\textsuperscript{\&} & 198.6
(107.2--300.6)\textsuperscript{\&} & 198.6
(107.2--300.6)\textsuperscript{\&} & 198.6
(107.2--300.6)\textsuperscript{\&} & 0.028* & 0.028* &
0.028*\tabularnewline
Disulphide (\selectlanguage{greek}µ\selectlanguage{english}mol/L) & & & & & & & & & & &\tabularnewline
Baseline & 10.65 (3.7--24.95) & 10.65 (3.7--24.95) & 10.65 (3.7--24.95)
& 16.2 (5.2--59.3) & 16.2 (5.2--59.3) & 16.2 (5.2--59.3) & 16.2
(5.2--59.3) & 16.2 (5.2--59.3) & 0.124 & 0.124 & 0.124\tabularnewline
Intraoperative 30 minutes & 9 (1.15--23.9) & 9 (1.15--23.9) & 9
(1.15--23.9) & 9.93 (2.25--32.1)\textsuperscript{\#} & 9.93
(2.25--32.1)\textsuperscript{\#} & 9.93 (2.25--32.1)\textsuperscript{\#}
& 9.93 (2.25--32.1)\textsuperscript{\#} & 9.93
(2.25--32.1)\textsuperscript{\#} & 0.930 & 0.930 & 0.930\tabularnewline
Postoperative 3 hours & 6.45 (1.5--23.35)\textsuperscript{\&} & 6.45
(1.5--23.35)\textsuperscript{\&} & 6.45 (1.5--23.35)\textsuperscript{\&}
& 10.35 (1.65--34.35)\textsuperscript{\#} & 10.35
(1.65--34.35)\textsuperscript{\#} & 10.35
(1.65--34.35)\textsuperscript{\#} & 10.35
(1.65--34.35)\textsuperscript{\#} & 10.35
(1.65--34.35)\textsuperscript{\#} & 0.314 & 0.314 & 0.314\tabularnewline
Postoperative 6 hours & 8.48 (3.8--19.2) & 8.48 (3.8--19.2) & 8.48
(3.8--19.2) & 11.2 (2.05--26.1)\textsuperscript{\#} & 11.2
(2.05--26.1)\textsuperscript{\#} & 11.2 (2.05--26.1)\textsuperscript{\#}
& 11.2 (2.05--26.1)\textsuperscript{\#} & 11.2
(2.05--26.1)\textsuperscript{\#} & 0.273 & 0.273 & 0.273\tabularnewline
Postoperative 18 hours & 5.88 (1.05--73.65)\textsuperscript{\&} & 5.88
(1.05--73.65)\textsuperscript{\&} & 5.88
(1.05--73.65)\textsuperscript{\&} & 10.5 (1--28.25) & 10.5 (1--28.25) &
10.5 (1--28.25) & 10.5 (1--28.25) & 10.5 (1--28.25) & 0.032* & 0.032* &
0.032*\tabularnewline
Disulphide/Native thiol level & Disulphide/Native thiol level &
Disulphide/Native thiol level & & & & & & & & &\tabularnewline
Basal & Basal & 4.72 (1.47--16.24) & 4.72 (1.47--16.24) & 4.72
(1.47--16.24) & 7.77 (1.95--82.25) & 7.77 (1.95--82.25) & 0.059 & 0.059
& 0.059 & 0.059 & 0.059\tabularnewline
Intraoperative 30 minutes & Intraoperative 30 minutes & 3.89
(0.51--16.96) & 3.89 (0.51--16.96) & 3.89 (0.51--16.96) & 5.66
(1.21--125.39)\textsuperscript{\#} & 5.66
(1.21--125.39)\textsuperscript{\#} & 0.217 & 0.217 & 0.217 & 0.217 &
0.217\tabularnewline
Postoperative 3 hours & Postoperative 3 hours & 3.34 (0.88--14.98) &
3.34 (0.88--14.98) & 3.34 (0.88--14.98) & 5.79
(1.05--37.58)\textsuperscript{\#} & 5.79
(1.05--37.58)\textsuperscript{\#} & 0.166 & 0.166 & 0.166 & 0.166 &
0.166\tabularnewline
Postoperative 6 hours & Postoperative 6 hours & 3.69 (1.39--11.57) &
3.69 (1.39--11.57) & 3.69 (1.39--11.57) & 5.22 (1.25--20.6) & 5.22
(1.25--20.6) & 0.040* & 0.040* & 0.040* & 0.040* & 0.040*\tabularnewline
Postoperative 18 hours & Postoperative 18 hours & 2.82
(0.77--28.56)\textsuperscript{\&} & 2.82
(0.77--28.56)\textsuperscript{\&} & 2.82
(0.77--28.56)\textsuperscript{\&} & 6.6 (0.58--20.44) & 6.6
(0.58--20.44) & 0.019* & 0.019* & 0.019* & 0.019* &
0.019*\tabularnewline
p\textless{}0,05 Mann--Whitney U test,
\textsuperscript{\#}p\textless{}0.05 compared with the baseline value
for Group GA, Wilcoxon signed-rank test,
\textsuperscript{\&}p\textless{}0.05 compared with the baseline value
for Group IB, Wilcoxon signed-rank test & *p\textless{}0,05
Mann--Whitney U test, \textsuperscript{\#}p\textless{}0.05 compared with
the baseline value for Group GA, Wilcoxon signed-rank test,
\textsuperscript{\&}p\textless{}0.05 compared with the baseline value
for Group IB, Wilcoxon signed-rank test & *p\textless{}0,05
Mann--Whitney U test, \textsuperscript{\#}p\textless{}0.05 compared with
the baseline value for Group GA, Wilcoxon signed-rank test,
\textsuperscript{\&}p\textless{}0.05 compared with the baseline value
for Group IB, Wilcoxon signed-rank test & *p\textless{}0,05
Mann--Whitney U test, \textsuperscript{\#}p\textless{}0.05 compared with
the baseline value for Group GA, Wilcoxon signed-rank test,
\textsuperscript{\&}p\textless{}0.05 compared with the baseline value
for Group IB, Wilcoxon signed-rank test & *p\textless{}0,05
Mann--Whitney U test, \textsuperscript{\#}p\textless{}0.05 compared with
the baseline value for Group GA, Wilcoxon signed-rank test,
\textsuperscript{\&}p\textless{}0.05 compared with the baseline value
for Group IB, Wilcoxon signed-rank test & *p\textless{}0,05
Mann--Whitney U test, \textsuperscript{\#}p\textless{}0.05 compared with
the baseline value for Group GA, Wilcoxon signed-rank test,
\textsuperscript{\&}p\textless{}0.05 compared with the baseline value
for Group IB, Wilcoxon signed-rank test & *p\textless{}0,05
Mann--Whitney U test, \textsuperscript{\#}p\textless{}0.05 compared with
the baseline value for Group GA, Wilcoxon signed-rank test,
\textsuperscript{\&}p\textless{}0.05 compared with the baseline value
for Group IB, Wilcoxon signed-rank test & *p\textless{}0,05
Mann--Whitney U test, \textsuperscript{\#}p\textless{}0.05 compared with
the baseline value for Group GA, Wilcoxon signed-rank test,
\textsuperscript{\&}p\textless{}0.05 compared with the baseline value
for Group IB, Wilcoxon signed-rank test & *p\textless{}0,05
Mann--Whitney U test, \textsuperscript{\#}p\textless{}0.05 compared with
the baseline value for Group GA, Wilcoxon signed-rank test,
\textsuperscript{\&}p\textless{}0.05 compared with the baseline value
for Group IB, Wilcoxon signed-rank test & *p\textless{}0,05
Mann--Whitney U test, \textsuperscript{\#}p\textless{}0.05 compared with
the baseline value for Group GA, Wilcoxon signed-rank test,
\textsuperscript{\&}p\textless{}0.05 compared with the baseline value
for Group IB, Wilcoxon signed-rank test & *p\textless{}0,05
Mann--Whitney U test, \textsuperscript{\#}p\textless{}0.05 compared with
the baseline value for Group GA, Wilcoxon signed-rank test,
\textsuperscript{\&}p\textless{}0.05 compared with the baseline value
for Group IB, Wilcoxon signed-rank test & *p\textless{}0,05
Mann--Whitney U test, \textsuperscript{\#}p\textless{}0.05 compared with
the baseline value for Group GA, Wilcoxon signed-rank test,
\textsuperscript{\&}p\textless{}0.05 compared with the baseline value
for Group IB, Wilcoxon signed-rank test\tabularnewline
\bottomrule
\end{longtable}

Table 4. Changes in Native and Total Thiol Levels Across Time Intervals\selectlanguage{english}
\begin{longtable}[]{@{}lllll@{}}
\toprule
& & Group IB & Group GA & p\tabularnewline
\midrule
\endhead
& & Median (minimum--maximum) & Median (minimum--maximum)
&\tabularnewline
Native thiol & Native thiol & & &\tabularnewline
& T1--T0 & 4.75 (-12 to 151.6) & -11.55 (-113.8 to 132.5) &
0.650\tabularnewline
& T2--T1 & -11.85 (-122.2 to 22.7) & -1.95 (-56.3 to 79.7) &
0.113\tabularnewline
& T3--T2 & 7.95 (-68.3 to 59.6) & -3.9 (-52.8 to 39.9) &
0.032*\tabularnewline
& T4--T3 & 13.35 (-164.1 to 110.5) & 4.05 (-92.5 to 89.1) &
0.571\tabularnewline
Total thiol & Total thiol & & &\tabularnewline
& T1--T0 & -7.75 (-141.2 to 175.3) & -20.5 (-92.8 to 41.7) &
0.339\tabularnewline
& T2--T1 & -20.05 (-118.6 to 21.9) & -2.5 (-72 to 70.3) &
0.021*\tabularnewline
& T3--T2 & 22.4 (-70.3 to 70.3) & -7.05 (-37.7 to 36.2) &
0.012*\tabularnewline
& T4--T3 & 8.35 (-179.6 to 224.9) & 6.45 (-62.8 to 89.8) &
0.940\tabularnewline
p\textless{}0,05 Mann--Whitney U test & *p\textless{}0,05 Mann--Whitney
U test & *p\textless{}0,05 Mann--Whitney U test & *p\textless{}0,05
Mann--Whitney U test & *p\textless{}0,05 Mann--Whitney U
test\tabularnewline
\bottomrule
\end{longtable}

Table 5. C-Reactive Protein Levels\selectlanguage{english}
\begin{longtable}[]{@{}llll@{}}
\toprule
& Group IB & Group GA & P\textsuperscript{a}\tabularnewline
\midrule
\endhead
& median (minimum--maximum) & median (minimum--maximum) &\tabularnewline
C-reactive protein (mg/dL) & & &\tabularnewline
Baseline & 0.1 (0--2.25) & 0.1 (0.1--6.31) & 0.727\tabularnewline
Intraoperative 30 minutes & 0.2 (0.1--1.68) & 0.16 (0.1--5.38) &
0.688\tabularnewline
Postoperative 3 hours & 0.1 (0.1--1.89) & 0.1 (0.1--5.15) &
0.706\tabularnewline
Postoperative 6 hours & 0.11 (0.1--2.83) & 0.23 (0.1--4.4) &
0.332\tabularnewline
Postoperative 18 hours & 0.66 (0.1--3.34)\textsuperscript{\&} & 0.75
(0.1--7.19)\textsuperscript{\#} & 0.406\tabularnewline
\textsuperscript{a}Mann--Whitney U test, \textsuperscript{\&}p=0.003
compared with the baseline value for Group IB, Wilcoxon signed-rank
test, \textsuperscript{\#}p=0.001 compared with the baseline value for
Group GA, Wilcoxon signed-rank test & \textsuperscript{a}Mann--Whitney U
test, \textsuperscript{\&}p=0.003 compared with the baseline value for
Group IB, Wilcoxon signed-rank test, \textsuperscript{\#}p=0.001
compared with the baseline value for Group GA, Wilcoxon signed-rank test
& \textsuperscript{a}Mann--Whitney U test, \textsuperscript{\&}p=0.003
compared with the baseline value for Group IB, Wilcoxon signed-rank
test, \textsuperscript{\#}p=0.001 compared with the baseline value for
Group GA, Wilcoxon signed-rank test & \textsuperscript{a}Mann--Whitney U
test, \textsuperscript{\&}p=0.003 compared with the baseline value for
Group IB, Wilcoxon signed-rank test, \textsuperscript{\#}p=0.001
compared with the baseline value for Group GA, Wilcoxon signed-rank
test\tabularnewline
\bottomrule
\end{longtable}

FIGURE LEGENDS

Figure. Postoperative Visual Analogue Scale Scores\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/image1/image1}

\end{center}
\end{figure}

(p \textless{} 0.001, Mann--Whitney U test, \textsuperscript{\#}p [?]
0.001 compared with the baseline value for Group GA, Wilcoxon
signed-rank test

\selectlanguage{english}
\FloatBarrier
\end{document}

