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.
The reform process is a dynamic process going on, especially the administrative and financial reform, which contributes to the work and directing operations towards success and continuous development, which requires determining the validity and the responsibility and the rights and duties of all officials in the school settings (within the formations educational institutions) for the purpose of reducing the administrative and financial corruption, and then ensure management efficient and effective way by taking advantage of the physical, financial and human resources available to achieve the greatest benefit at the lowest cost to the fact that the follow-up performance on an ongoing basis in accordance with the specific of powers
... Show MoreThe Sebkha is considered the evaporative geomorphological features, where climate plays an active role. It forms part of the surface features in Mesopotamia plain of Iraqi, which is the most fertile lands, and because of complimentary natural and human factors turned most of the arable land to the territory of Sebkha lands. The use satellite image (Raw Data), Landsat 30M Mss for the year 1976 Landsat 7 ETM, and the Landsat 8 for year 2013 (LDCM) for the summer Landsat Data Continuity Mission and perform geometric correction, enhancements, and Subset image And a visual analysis Space visuals based on the analysis of spectral fingerprints earth's This study has shown that the best in the discrimination of Sebkha Remote sensing techniques a
... Show MoreThis research deals with one scene from the movie Romeo and Juliet, which is the balcony scene, due to the importance of this scene in the formation of the construction of the subsequent events of the movie.
The first chapter contained the methodological framework of the research, where the research problem was identified in how Zeffirelli dealt with the balcony scene in the play Romeo and Juliet and enriched it in the cinematic language with a comparison with the original text of the scene. In the balcony scene with comparative parts between the film and the text and the limits of the research that was limited to the film Zeffirelli and the translated text by Munis Taha Hussein.
The second chapter contained the theoretic
... Show MoreThe research starts from studying the contractual budget, which is one of the modern trends in preparing public budgets, both operational and capital, in addition to meeting the requirements of the global trend to achieve sustainable growth in all fields, whether financial or non-financial, and tools for the contractual budget have been identified (participation contracts, planning Implementation, monitoring) and studying its impact in supporting sustainable development through its dimensions (economic, social, and environmental). The method of the questionnaire was adopted as a main tool in collecting information on research variables and distributing it to a sample of (70) individuals who dictate positions of professional respo
... Show MoreStudied competence spam to malicious moth figs at temperatures and Kagafat host different results showed that female intruder, despite their ability to shell larvae host and when densities of different, but it is able to lay eggs at a temperature of 14 + or -1 and finally urged the efficiency spam to malicious affected heavily host and that the greater the intensity of the host spam increased efficiency and its performance life
The research aims to achieve a set of the most important objectives of the review of the role of creative administrative leadership in achieving aspects of economic reform in various government institutions and indicate the role of supervisory awareness of administrative leadership in the revitalization of the role of the internal control system to achieve the best use of available resources. This paper deals with three problems is the loss of financial resources of the state as a result of the growing phenomenon of administrative and financial corruption in the majority of government institutions, and the weakness of the role of the internal control system in the province on the resources available and to achieve the best use of these reso
... Show MoreThis study examined the phenomenon of unemployment in Iraq and the extent of the contribution of these loans granted by banks to finance small and medium enterprises in reducing their rates. The temporal boundaries of the study included the period between (2012-2018). The spatial boundaries consisted of random sampling of six Iraqi banks) Where the government banks included (Rafidain, Rasheed and industrial), private banks included (the Iraqi Islamic Bank and the Gulf Commercial Bank and the Bank of the Middle East). In order to achieve the objective of the research in the light of the hypotheses drawn up, the research divided into three topics, the first section highlighting the reality of small and medium enterprises in Iraq and the lo
... Show Moreمقدمة
تدور الدراسة في علم الاقتصاد المنزلي حول احتیاجات الانسان الضروریة لاستمرار الحیاة ومواقف في محیط
الاسرة وتفاعل مع ظروف البیئة المحیطة بھ .والتي تكون دائمة التغییر لذلك یمكن تعریف علوم وفنون الاقتصاد
المنزلي وفنونھ انھا عبارة عن مجموعة منظمة من المعارف والعلوم تتركز في محور الاسرة والمنزل حیث ینمو
ویتطور الانسان بالعلاقات الانسانیة والنواحي الاقتصادیة والاجتماعیة من جھة والنواحي العلمیة وا
Abstract:
Saudi Arabia and United States long relation could present an important
subject to understand alliance kind in international relations types. We trying
in this study to diagnose and analyze the Saudi Arabia and United States
model to find balance and unbalance statues and its influence on the
directions of Saudi Arabia foreign policy positions.
We divided the study in two parts, each part have many sections. The
first part deal with the historian emergence of Saudi Arabia state and its
development in three stages including its foreign relations with regions and
international powers. While the second part was dedicated in analyzing and
understanding the mechanism and active facts that drawing the Sa