Objective : Sciatic nerve block (popliteal approach) and femoral N block is a new technique other than general anesthesia in below knee surgery because it provides adequate muscle relaxation, with good intraoperative and post-operative analgesia. Nefopam is non opioid, non-respiratory depressant and non-sedative was mixed with local anesthetics drug to study the effects. This study was done to compare the onset and duration of sensory and onset time and duration of action of motor block following administration of either bupivacaine alone with administration of bupivacaine and Nefopam in patients undergoing below knee lower limb surgeries under ultrasound guided regional anesthesia.
Methods: 100 patients with American society of anesthesiologists (ASA) 2 / 3/4 patients between 25 and 85 years who underwent elective and emergency lower limb surgeries randomly allocated into two group, each group has 50 patients by a sealed envelope technique to receive 20 ml of 0.5% Bupivacaine with 2 ml of normal saline in Group BS and 20 ml of 0.5% Bupivacaine with 2ml (20mg) of Nefopam in the second group (Group BN). The onset time, duration time of both sensory and motor blocking were seen and compared between the two groups.
Results : The onset time of both sensory and motor blockade was shorter in Group BN (bupivacaine with nefopam) when compared to Group BS (bupivacaine and normal saline) (p<0.0001). The duration of both sensory and motor blockade was longer in Group BN when compared to Group BS (p<0.0001). There were no significant hemodynamic changes (PR, BP,SPO2) in both groups. Also there is no any side effect or any complication.
Conclusion Nefopam when mixed with Bupivacaine in Sciatic nerve block and femoral nerve block in below knee surgeries shortens the onset time and prolongs the duration of action of both sensory and motor blockade without any systemic side effects and give excellent intra and postoperative analgesia.
Background: Pain is one of the most postoperative complications of surgical wound especially within first 24 hrs. leading to delay hospital discharge, stress gastritis and increasing blood pressure. As wound infiltration with long acting local anesthetic (bupivacaine) has been proved to be effective after orthopedic surgeries especially total hip and knee replacements.Objective: our study was designed to determine theeffectiveness of local infiltration of 0.5% of bupivacainebefore closure of surgical wounds in controllingpostoperative pain and improve patient’s outcome after totalhip and knee replacement surgeries in first 24hrspostoperative period.Methods: Twenty patients from class I (healthy patients) and class II (patients mild sys
... Show MoreBackground: Postoperative pain is one of the main complications following impacted mandibular third molar (IMTM) surgery. Objectives: The aim of this study was to assess the effect of the local application of bupivacaine on reducing early postoperative pain following IMTM surgery. Material and methods: A prospective, single-blinded, randomized controlled study was conducted on 40 patients who had undergone the surgical removal of an IMTM under local anesthesia. In the study group (n = 20), absorbable gelatin sponge (AGS) soaked in 3 mL of 0.5% plain bupivacaine hydrochloride was locally applied in the post-extraction socket. In the control group (n = 20), AGS soaked in 3 mL of normal saline was used. Pain intensity was assessed using a pa
... Show MoreTransient drop in the heart beat or transient heart block (AVB) may be consider the main cause of syncope or presyncope inpatients with bifascicular block and syncope According to the Guidelines for cardiac pacing pacemaker consider part of treatment. Aims of our study were to evaluate whether there is role for EPS in patients BFB and to evaluate the symptoms after pacing. 42 patients were enrolled in this study, with mean age value (63.4± 12.2years), suffer from interventricular conductive defect and syncope; patients underwent EPS on admission time, and pacemaker implantation accordingly and programmed follow up for the device in the last four years. Our patients were 25 (59.5%) male and 17 (40.5%)female, all of them with syncope o
... Show MoreThrust blocks and restraint joints are the two most popular methods of counteracting the thrust force that generated at pipe fittings (bends, Tee, wye, reducers, dead ends, etc…). Both systems perform the same function, which is to prevent the joints from separating from the pipes. The aim of the study is to review previous studies and scientific theories related to the study and design of thrust blocks and restraint joints to study the behavior of both systems under thrust force and to study the factors and variables that affect the behavior of these systems. The behavior of both systems must be studied because they cannot be abandoned, as each system has conditions whose use is more feasible, scientific, and economic
... Show MoreThe research aims to estimate missing values using covariance analysis method Coons way to the variable response or dependent variable that represents the main character studied in a type of multi-factor designs experiments called split block-design (SBED) so as to increase the accuracy of the analysis results and the accuracy of statistical tests based on this type of designs. as it was noted in the theoretical aspect to the design of dissident sectors and statistical analysis have to analyze the variation in the experience of experiment )SBED) and the use of covariance way coons analysis according to two methods to estimate the missing value, either in the practical side of it has been implemented field experiment wheat crop in
... Show MoreIn this paper we have made different regular graphs by using block designs. In one of our applicable methods, first we have changed symmetric block designs into new block designs by using a method called a union method. Then we have made various regular graphs from each of them. For symmetric block designs with (which is named finite projective geometry), this method leads to infinite class of regular graphs. With some examples we will show that these graphs can be strongly regular or semi-strongly regular. We have also propounded this conjecture that if two semi-symmetric block designs are non-isomorphic, then the resultant block graphs of them are non-isomorphic, too.
Osteoarthritis is the most prevalent arthritic disease and a leading cause of disability. The pathogenesis of osteoarthritis involves multiple etiologies, including variable degree of synovial inflammation. Metformin and pioglitazone could potentially reduce the levels and activity of inflammatory mediators. This may consider as a new therapeutic approach added to the current used drugs in an attempt to decrease the pain, inflammation, and improve daily activity and quality of life in patients with knee osteoarthritis.
This study designed to evaluate the clinical utility of using metformin or pioglitazone as anti-inflammatory agents in combination with non-steroidal anti-inflammatory drugs (NSAID) of selective type of cyclooxygen
... Show MoreLeft bundle branch block (LBBB) is a common finding in electrocardiography, there are many causes of LBBB.
The aim of this study is to discuss the true prevalence of coronary artery disease (CAD) in patients with LBBB and associated risk factors in the form of hypertension and diabetes mellitus.
Patients with LBBB were admitted to the Iraqi heart center for cardiac disea
Suppose that is a finite group and is a non-empty subset of such that and . Suppose that is the Cayley graph whose vertices are all elements of and two vertices and are adjacent if and only if . In this paper, we introduce the generalized Cayley graph denoted by that is a graph with vertex set consists of all column matrices which all components are in and two vertices and are adjacent if and only if , where is a column matrix that each entry is the inverse of similar entry of and is matrix with all entries in , is the transpose of and . In this paper, we clarify some basic properties of the new graph and assign the structure of when is complete graph , complete bipartite graph and complete
... Show More