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Fentanyl

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Sourced in Germany, Finland, Belgium, United States

Fentanyl is a synthetic opioid that is used as a pharmaceutical product in medical settings. It is a potent analgesic that is primarily used to manage severe pain in patients, particularly those with cancer or other chronic pain conditions. Fentanyl is available in various forms, including transdermal patches, lozenges, and injectable solutions. The product is intended for use under the supervision of healthcare professionals, as it carries significant risks of abuse and overdose.

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59 protocols using fentanyl

1

Anesthesia and Euthanasia Protocol for Mice

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For all the above-mentioned surgical procedures, on the day of surgery and on the day of sacrifice mice were anesthetized as previously described25 (link),38 (link). Briefly, mice were anesthetized with midazolam (5 mg/kg, Roche Diagnostics, Basel, Switzerland), medetomidine (0.5 mg/kg, Orion, Espoo, Finland) and fentanyl (0.05 mg/kg, Janssen Pharmaceutical, Beerse, Belgium). The adequacy of the anesthesia was monitored by keeping track of the breathing frequency and the response to toe pinching of the mice. After surgery, mice were antagonized with atipamezol (2.5 mg/kg, Orion, Espoo, Finland) and fluminasenil (0.5 mg/kg, Fresenius Kabi, Bad Homburg, Germany). Buprenorphine (0.1 mg/kg, MSD Animal Health, Keniworth, NJ, USA) was given after surgery to relieve pain. On the day of sacrifice mice underwent deep anesthesia with midazolam (5 mg/kg, Roche Diagnostics, Basel, Switzerland), medetomidine (0.5 mg/kg, Orion, Espoo, Finland) and fentanyl (0.05 mg/kg, Janssen Pharmaceutical, Beerse, Belgium) and were then euthanized by exsanguination.
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2

Assessing Hepatic VLDL Production in Mice

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In the second experiment, at week 12, mice (n = 8) were fasted for 4 h (9:00–13:00) and anaesthetized by the intraperitoneal injection (once) of 6.25 mg/kg Acepromazine (Alfasan, Woerden, The Netherlands), 6.25 mg/kg Midazolam (Roche, Mijdrecht, The Netherlands), and 0.31 mg/kg Fentanyl (Janssen-Cilag, Tilburg, The Netherlands).32 (link) Anaesthesia was maintained by intraperitoneal injection (three times; every 45 min) of 0.03 mg/kg Acepromazine, 0.03 mg/kg Midazolam, and 0.001 mg/kg Fentanyl.32 (link) To ensure a proper deep plane of anaesthesia throughout the experimental procedure, the reflexes of mice were checked by pinching the toes of the foot, and body temperature was monitored and maintained using a heating pad. Hepatic VLDL production was assessed as described under Expanded Methods in the Supplementary material online. Commercial kits were used for the measurement of VLDL-TG, -TC, and -PL and -protein.
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3

Stereotaxic Viral Injection for Dentate Gyrus Transduction

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The following surgical procedures were performed under deep Medetomidin (Domitor; Pfizer, New York City, NY, USA), Midazolam (Dormicum; Roche, Basel, Switzerland) and Fentanyl (Janssen Pharmaceutica, Beerese, Belgium) anesthesia (150 μg Medetomidin, 2 mg Midazolam, 5 μg Fentanyl per kg body weight i.m. initially and additional injections as needed). Animals were placed in a Kopf stereotaxic device (Kopf Instruments, Tujunga, CA, USA). Two small holes (1.5-2.0 mm diameter) were drilled in the skull at −3.8 mm from Bregma and 2.2 mm laterally at both hemispheres. A NanoFil syringe (World Precision Instruments, Inc., Sarasota, FL, USA) with a 35 gauge beveled needle (NF35BV-2; World Precision Instruments) was used to slowly inject 0.75 μl of the viral solution at 3.2 mm and 3.7 mm below the brain surface into the dentate gyrus (DG; both hemispheres).
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4

Stability of Fentanyl and Ketamine Solutions

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Fentanyl and ketamine were obtained from manufacturers commonly used in Indonesian hospitals; Fentanyl from Janssen Pharmaceutical, Belgium and ketamine from Combiphar, Indonesia. The dextrose 5% solution was obtained from Widatra, Sidoarjo, Indonesia. The medications were assessed at the concentrations typically used in an intensive care unit. Three sets of each medication solutions were prepared for analysis. The solutions were prepared by measuring (by syringe) the required volume of each drug solution into a 50 mL volumetric flask and then making it up to a volume with a dextrose 5% solution. The reconstituted medications were stored in 50 mL syringes in an open room under ambient light, temperature and humidity. Room temperature and humidity were monitored during experimentation and were within the ranges of 25-28°C and 70-80% relative humidity (RH). Five-millilitre (mL) samples were drawn for visual inspection and pH measurement, while a 1 mL sample was taken for HPLC assay at each sampling time.
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5

Fibrin Hydrogel Nerve Conduit for Cell Transplantation

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To ensure a spatial localization of the transplanted cells, we decided to use a clinically approved fibrin hydrogel (ARTISS®, Baxter, Deerfield, IL, USA), as preliminary results showed a high biocompatibility and metabolic activity over a long culture period in vitro (data not shown). Cell-loaded conduits with a length of 25 mm and a 2 mm wall thickness were prepared by mixing 3 × 106 cells in standard medium and thrombin solution at a 1:10 ratio. Afterwards the fibrinogen solution was allowed to polymerize in a sterile syringe with a centered metal rod to create a 2 mm lumen. Initial polymerization was carried out for 30 minutes, and after the removal from the syringe, the fibrin conduit was hardened for two hours in complete medium, before gently opening it longitudinally with micro scissors in order to be put around the nerve autograft (Figure 1G). Pre-operative anesthesia was initiated by intramuscular injection of 0.02 mg/kg fentanyl (Janssen, Germany), 1.0 mg/kg midozilam (Ratiopharm, Ulm, Germany) and 0.2 mg/kg medetomidin (Orion, Espoo, Finnland). Anesthesia was post operatively antagonized with 0.03 mg/kg naloxone (Bristol myers Squibb, New York, NY, USA), 0.1 mg/kg flumazenile (Roche, Basel, Switzerland) and 1.0 mg/kg atipamezole (cp-pharma, Burgdorf, Germany).
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6

Hind Limb Ischemia Model in Mice

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This study was performed in accordance with Dutch government guidelines and the Directive 2010/63/EU of the European Parliament. All experiments were approved by the committee on animal welfare of the Leiden University Medical Center (approval reference number 12029). C57BL/6 male mice, aged 8 to 12 weeks (Harlan), were housed in groups of four or five mice, with free access to water and regular chow. For Mef2a-inhibition experiments, mice were given intraperitoneal (i.p.) injections of 1 mg (∼40 mg/kg) GSO in PBS or PBS alone at 10, 7, and 4 days directly before surgery and at 3, 7, and 10 days after surgery. Mice were anesthetized by i.p. injection of midazolam (8 mg/kg, Roche Diagnostics), medetomidine (0.4 mg/kg, Orion), and fentanyl (0.08 mg/kg, Janssen Pharmaceuticals). Unilateral hind limb ischemia was induced by electrocoagulation of the left femoral artery proximal to the superficial epigastric artery and proximal to the bifurcation of the popliteal and saphenous artery (double ligation model).24 (link) After surgery, anesthesia was antagonized with flumazenil (0.7 mg/kg, Fresenius Kabi), atipamezole (3.3 mg/kg, Orion), and buprenorphine (0.2 mg/kg, MSD Animal Health).
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7

Hind Limb Ischemia Recovery Assessment

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Blood flow recovery to the ligated hind limb was measured over time using laser Doppler perfusion imaging (LDPI) (Moor Instruments) before and directly after surgery and at 3, 7, 10, and 14 days after surgery. For LDPI measurements, mice were anesthetized by i.p. injection of midazolam (8 mg/kg, Roche Diagnostics) and medetomidine (0.4 mg/kg, Orion). Before each measurement, mice were placed in a double-glazed pot and perfused with water at 37°C for 5 min. After LDPI, anesthesia was antagonized by subcutaneous injection of flumazenil (0.7 mg/kg, Fresenius Kabi) and atipamezole (3.3 mg/kg, Orion). LDPI measurements in the ligated paw were normalized to measurements of the unligated paw as the internal control. After the last LDPI measurement at day 14, analgesic fentanyl (0.08 mg/kg, Janssen Pharmaceuticals) was administered subcutaneously and mice were sacrificed via cervical dislocation. The adductor, gastrocnemius, and soleus muscles were harvested and either snap-frozen or fixed in 4% paraformaldehyde (PFA).
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8

Maternal Biometrics and Tissue Analysis

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Between 08.00 and 10.00 h, unfasted pregnant dams (n = 10 per diet, per age) were weighed and anaesthetized (10 μl g−1 fentanyl‐fluanisone:midazolam in sterile water, 1:1:2; i.p.; Janssen Animal Health, Beerse, Belgium). A cardiac blood sample was taken before death by cervical dislocation. Liver and retroperitoneal white adipose tissue (WAT) were dissected, weighed and snap frozen in liquid nitrogen for western blotting. Maternal skeletal muscle (biceps femoris) was also dissected and snap frozen. Blood glucose concentrations were measured using a hand‐held glucometer (One Touch Ultra; LifeScan, Johnson & Johnson Medical Ltd, Livingston, UK). At D19, the maternal liver was also fixed in 4% paraformaldehyde, dehydrated and embedded into paraffin wax before sectioning at 8 μm and staining with haematoxylin and eosin. Tissues and blood taken from dams in the previously published cohort (Sferruzzi‐Perri et al. 2013), contributed to the samples used for biometrical and biochemical analyses on the mother and placental gene expression.
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9

Particle Inhalation in Cftr Mutant Mice

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Three Cftr mutant and three WT mice (female, aged 10 - 12 weeks, body weight 17.7 - 20.8 g) were used. There were no significant differences in age or body weight between mutant and WT mice. For particle inhalation, animals were deeply anaesthetized by intraperitoneal (i.p.) injection of a mixture of medetomidine (Domitor®, Pfizer GmbH, Karlsruhe, Germany; 500 μg/Kg), midazolam (Dormicum®, Hoffmann-La Roche AG, Grenzach-Wyhlen, Germany; 5 mg/Kg) and Fentanyl (Fentanyl®, Janssen-Cilag GmbH, Neuss, Germany; 50 μg/Kg). For lung fixation immediately after inhalation, anesthesia was deepened with i.p. injection of a mixture of xylazin (Rompun®, Bayer Vital GmbH, Leverkusen; 5 mg/Kg) and ketamine (Ketamin 10%, WDT eG, Garbsen, Germany; 100 mg/Kg) prior to exsanguination by cutting the abdominal aorta. For 24-h examinations, anesthesia was antagonized by subcutaneous injection of atipamezole (Antisedan®, Pfizer GmbH Karlsruhe, Germany; 2.5 mg/kg), flumazenil (Anexate®, Hoffmann-La Roche AG, Grenzach-Wyhlen, Germany; 500 μg/Kg), and naloxone (Narcanti®, Janssen Animal Health, Neuss, Germany; 1.2 mg/Kg). For lung fixation at 24 h, a mixture of xylazin and ketamine was injected prior to euthanasia by exsanguination as above.
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10

Anesthesia and Surgical Procedures in Porcine Studies

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All experiments were performed in accordance with the German legislation governing animal studies. Official permission was granted from the governmental animal care office (Landesamt für Natur, Umwelt und Verbraucherschutz Nordrhein-Westfalen, Recklinghausen, Germany). Female German landrace pigs from a disease-free barrier breeding facility were housed in ventilated rooms and allowed to acclimatize to their surroundings for a minimum of 5 days before surgery. The animals, weighing around 60 kg, were fasted 12 hrs prior to the experiments. For premedication, the animals received an intramuscular injection of 4 mg kg−1 azaperone (Stresnil, Janssen, Germany). Anesthesia was induced by intravenous injection of 3 mg kg−1 propofol followed by oral intubation. The animals were ventilated with 40% oxygen at 20–26 bpm and a tidal volume of 10 mL kg−1 to keep the end tidal partial carbon dioxide tension (pCO2) between 36 and 42 mmHg. Anesthesia was maintained with isoflurane at a concentration of 1%–1.5% (Forane, Abbott, Germany) and fentanyl (fentanyl, Janssen, Germany) at a concentration of 3-4 mg kg−1. To compensate for basic fluid requirements volume, animals received Ringer's lactate (RL) solution at a rate of 4 mL kg−1; after laparotomy, the constant infusion rate was set to 8 ml kg−1 and not changed until infliction of trauma.
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