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.
Municipal solid waste is one of the most important environmental problems in the world and is an important source of environmental pollution and contributes significantly to the pollution of the basic environmental elements of soil, water and air. The management of municipal waste in general is a process of monitoring, collection, treatment or recycling if possible or disposal of waste. This term is used for waste produced by some human activities. States provide this process to mitigate the negative effects of waste on the environment, health and appearance of the city. It is possible to find solutions to the problem of solid waste and make it an important source of income and contribute to securing employment oppor
... Show MorePurpose: In view of the trend toward using international financial reporting standards when generating financial statements, we looked at the interaction between audit services and non-audit services for auditors in the context of actuarial services for insurance firms. CPAs are authorized to work in banks and insurance businesses, but those with a practicing license obtained after earning a higher academic degree are not. Design/methodology/approach: A small number of auditing firms control the decisions issued by the Iraqi Accountants Association, monopolizing audit services in banks and insurance businesses. In the case of actuarial services used in reserve estimation, they are credited to an external party's account withou
... Show MoreForeign trade receives a good deal of economists' attention for its active contribution to economic growth, and imports of goods and services that could not be produced locally constitute an important share of the local economy. Agricultural imports constitute an important share of the total imports due to their role in fulfilling the needs of local markets; however, the agricultural sector in Iraq contributes no more than a limited share of the country's need, which has encouraged the import of a variety of fruits, vegetables and strategic crops and different types of red and white meat. For the sake of identifying the factors affecting the demand on agricultural imports in Iraq, the following factors has been analyzed: th
... Show MoreThis study aimed at an analytical comparison of the Internal Auditing Standards issued by the Institute of Internal Auditors (IIA) and the Guidance Manual for Audit Units issued by the Federal Audit Bureau to show the compatibility and differences between them and the possibility of applying the IIA standards to economic units in Iraq. The guideline was generally not covered by all the internal audit units. There is a lack of keeping pace with changes in internal auditing at the international level and there is a need to strengthen the Guideline on Internal Auditing Standards II A), which is characterized by the preparation of an internal document containing the objectives, powers and responsibilities of the internal audit work as well a
... Show MoreBackground: Mitral regurgitation (MR) is the most commonly encountered valve lesion in modern clinical practice. Severe mitral regurgitation may cause systolic dysfunction. Left ventricular ejection fraction may not be an accurate measurement of LV function in patients with mitral insufficiency. Myocardial performance index (MPI) is a simple non invasive measure of myocardial function. Methods: The study involved 50 patients with valvular mitral regurgitation and 50 healthy subjects as a control group. Transthoracic echocardiography was carried out for all patients and control group. The echocardiographic measurements included left ventricular end diastolic and end systolic dimensions, left atrial diameter, ejection fraction (EF), and myoca
... Show MoreConstitute the relationship between the director and actor mainstay chock done to show art in film and television , both of which occupy what a big role in the mission accomplishment . The leadership of the director of the artwork in various joints require two features two important ( creativity and administration ) , The capabilities director of creative serves as an added intellectual and aesthetic saturated sensation that leaves its impact on all the technical elements involved in done. Either trait administration and leadership it is what requires multiple skills in dealing on according to technical standards and moral and humanitarian allow the transfer of ideas , concepts and visions to those elements to embody and implement the ki
... Show MoreThe Arabic calligraphy, in the early days of Islam, was used for the purpose of decorating the walls of mosques from inside and outside. Hence, this decorative art must be actively involved in enriching the designs of Islamic fabrics and costumes because it has a highly qualified and aesthetically pleasing look and expresses the originality of the Arab spirit. The research is divided into two section: the first section included the following topics: First "A historical overview of the art of decoration in Islamic Arab thought". Second "linear formations of decorative designs, and the subject of intellectual aesthetic taste of the art of decorating. This section tackles two subsections: first "the beauty of thought between the function an
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