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.
Abstract
The research to have a clear perceptions about the knowledge value added to assess the knowledge resources of the Iraqi private banks, depending on the value added methodology of the proposed defined (Housel & Bell, 2001), which assumes that the knowledge value added come through synergetic relationship between knowledge resource and information technology, trying to the possibility of mainstream theory and its application in the Iraqi environment and interpretation of results, and on this basis was launched search of a research problem took root synergetic nature of the relationship between knowledge (human) resource and
... Show MoreIn a resource-limited world, there is an urgent need to develop new economic models, from the traditional unsustainable industrial model of product consumption and disposal, to a new model based on the concepts of sustainability in its comprehensive sense, the so-called circular economy, using fewer resources in manufacturing processes and changing practices in product disposal to waste, by removing its use, recycling and manufacturing to start another manufacturing process. In an era of intense competition in domestic and global markets, the importance of the circular economy is highlighted in its ability to strengthen the competitiveness of enterprises in those markets, by reducing the cost and increasing the quality of the pro
... Show MoreThe Child's theatre was and still is the most investing art for masks of all kinds (partial and total) for suspense, aesthetic and artistic purposes that meet the requirements of those performances. Here the actor's performance is associated with two tools, i.e. the body and the mask, where it has become a must to search for the performance transformations required in order to achieve the highest level of the right performance through this dualism. This urged the researcher to address this problem. Thus, the researcher has put forward an objective to identify the transformations of the character's performance between the body and the mask in the child's theatre shows. The research consists of a methodological framework and a theoretical
... Show MoreResearch indicates that the second half of the twentieth century marked large interests in the service industry by government and private organizations in that one, and the service industry has become the bedrock of plans in achieving economic and social development. From this standpoint felt specialists and researchers the importance of transport modes, including rail, which should be available between Almnltq Civil populated as services organized by the competent authorities to achieve the active participation of citizens in economic and social development in the region and that the term services means economic activities, which are the results Pollack concrete such as accepting the situation and satisfaction them or satisfacti
... Show MoreThis study aims at examining the effectiveness of using the narrative approach in teaching the Interpretation of the Qur'an course in the development of conceptual comprehension among first-grade middle school female students. To achieve the objective of this study, a quantitative quasi-experimental design has been used. The sample consisted of first-grade middle school female students at "the third middle school" in Buraidah city, as this school suits the objective of the study. A test of conceptual understanding has been built by the researchers according to a list of conceptual understating skills at a significance level of α ≤ 0.05. Results have shown that there are statistically significant differences at the level (α ≤ 0,05)
... Show MoreThe research aimed to demonstrate the possibility of benefiting from the coordination between real estate and income tax as the independent variable on the tax outcome as the dependent variable as the dependent variable. Which were practiced within rented buildings, as information was obtained from real estate owners, and the annual controls for the year 2021 were relied upon in the process of calculating the tax amounts expected to be obtained. used in the tax inventory process lacks seriousness and continuous updating
In this research, a selection of some mineral water was selected on the basis of being the most marketed by the owners of shops in Najaf province, with six types, where daily samples of this water were taken by 50 ml for two months from (1/11/2018 -1/1/2019). The following ions concentrations were measured (Br-, Cl-, F-, NO3-, SO42-, Na+, K+, Ca2+, Mg2+), pH and the electrical conductivity were measured and the results were compared with the allowable rates according to the international organizations. It was noted that they conform to international and Iraqi standards.
Background: Esthetic treatment is the options of patient seeking orthodontic treatment. Therefore this study was conducted to measure the concentration of Aluminum, Nickel, Chromium and Iron ions released from combination of monocrysralline brackets with different arch wires immersed in artificial saliva at different duration, to evaluate the corrosion point on different parts of the orthodontic appliances before and after immersion in artificial saliva, and to evaluate the corrosion potential of each group of the orthodontic appliances. Material and methods: Eighty orthodontic sets prepared. Each set represents half fixed orthodontic appliance, from the central incisor to the first molar, for the maxillary arch, each set consisted of molar
... Show MoreMany of the dynamic processes in different sciences are described by models of differential equations. These models explain the change in the behavior of the studied process over time by linking the behavior of the process under study with its derivatives. These models often contain constant and time-varying parameters that vary according to the nature of the process under study in this We will estimate the constant and time-varying parameters in a sequential method in several stages. In the first stage, the state variables and their derivatives are estimated in the method of penalized splines(p- splines) . In the second stage we use pseudo lest square to estimate constant parameters, For the third stage, the rem
... Show More