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Surgical procedures for intraoperative oIGF-1 infusion To test the acute effects of oIGF-1 on anabolic signaling pathways, pregnant Columbia-Rambouillet mixed-breed sheep with ewes carrying either a singleton fetus (n = 1) or twin fetuses (n = 3), underwent maternal laparotomy and hysterotomy under general anesthesia for fetal catheter placement at 136 1 day gestation

The most clinically relevant adverse effect is dose- and rate-dependent chest-wall rigidity, particularly after rapid bolus administration, which may compromise ventilation and necessitate immediate airway support or neuromuscular blockade (118, 120122)

In the subsequent months, the patient retired from his job due to a back injury exacerbated by physical strain

A central driver of these benefits is vascular repair