Background: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intravenous regional anaesthesia.Methods: In prospective, randomized study, sixty patient ASA physical status I, aged 20-50years underwent surgeries on distal regions of upper limbs, patient assigned randomly into 3 groups each of 20 patients, group I received 30ml of 0.5% lidocaine (150mg), group II received 30ml of mixing 0.5% of lidocaine (100mg) plus 30mg ketamine, while group III received 30ml of mixing 0.5% lidocaine (100mg) plus 30mg ketamine plus 2mg atracurium. All the results were tabulated and analyzed statistically with student's unpaired t-test and chi-square test. Results: Addition of 30mg of ketamine to 0.5% lidocaine resulted in rapid onset of sensory block, motor block, and lower visual analogue scale scores for pain compared with the group that received lidocaine only. The addition of atracurium to the combination of lidocaine and ketamine resulted in improved operating conditions and rapid onset of both sensory and motor blocks with less pain during surgery.Conclusions: drug combination of ketamine, atracurium and low dose of lidocaine lead to rapid onset of sensory block, motor block, lower VAS score for pain, and decrease adverse effect of Bier’s block accompany lidocaine alone, decrease drowsiness which accompany ketamine use alone in IVRA
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This paper presents the study and analysis, analytically and numerical of circular cylindrical shell pipe model, under variable loads, transmit fluid at the high velocity state (fresh water). The analytical analysis depended on the energy observation principle (Hamilton Principle), where divided all energy in the model to three parts , strain energy, kinetic energy and transmitted energy between flow and solid (kinetic to potential energy). Also derive all important equations for this state and approach to final equation of motion, free and force vibration also derived. the relations between the displacement of model function of velocity of flow, length of model, pipe thickness, density of flowed with location coordinate x-axis and angle
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In this paper, we used two monomers, 3,3',4,4'-benzophenone tetracarboxylic dianhydride (BTDA) and m,m'-diaminobenzophenone (m, m’-DABP), to produce polyamide acid and then converted it to polyimide (PI). The effects of phosphoric acid (H3PO4) molarity (1, 2, and 3 M) on the structural, thermal, mechanical, and electrical characteristics of the polyimides/polyaniline (PI/PANI) nanocomposites were studied. Two sharp reflection peaks were developed by the addition of PANI to PI. When 3 M H3PO4 is added, the crystalline sharp peak loses some of its intensity. The complex formation of PI/PANI-H3PO4 was confi
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This study aims to explore the potential mediation role of person-centeredness between the effects of the work environment and nurse reported quality and patient safety. A quantitative cross-sectional survey collected data from 1055 nurses, working in medical and surgical units, in twelve Malaysian private hospitals. The data collection used structured questionnaires. The Hayes macro explored the mediation effect of person-centeredness between the associations of work environment dimensions and care outcomes, controlling nurses’ demographics and practice characteristics. A total of 652 nurses responded completely to the survey (61.8% response rate). About 47.7% of nurses worked 7-h shifts, and 37.0% were assigned more than 15 pati
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