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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Aneurysms of the cortical branches of the middle cerebral artery (MCA) are rare. They usually are secondary to traumatic or infectious etiologies and are rarely idiopathic. The specific characteristics of idiopathic aneurysms in such location are not well defined in the literature. The authors report a rare case of a ruptured giant idiopathic cortical MCA aneurysm with review of the available literature on this clinical entity.
A 24-year-old female presented with headache, disturbed level of consciousness, and right-sided weakness. Imaging studies showed a left frontoparietal intracer
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This study aims to derive a general relation between line loads that acting on two-way slab system and the equivalent uniformly distributed loads. This relation will be so useful to structural designer that are used to working with a uniformly distributed load and enable them to use the traditional methods for analysis of two-way systems (e.g. Direct Design Method). Two types of slab systems, Slab System with Beams and Flat Slab Systems, have been considered in this study to include the effect of aspect ratio and type of slab on the proposed relation. Five aspect ratios, l2/l1 of 0.5, 0.75, 1.0, 1.5 and 2.0, have been considered for both types of two-way systems.
All necessary finite element analyses have been executed with SAFE Soft
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The calculation of the oil density is more complex due to a wide range of pressuresand temperatures, which are always determined by specific conditions, pressure andtemperature. Therefore, the calculations that depend on oil components are moreaccurate and easier in finding such kind of requirements. The analyses of twenty liveoil samples are utilized. The three parameters Peng Robinson equation of state istuned to get match between measured and calculated oil viscosity. The Lohrenz-Bray-Clark (LBC) viscosity calculation technique is adopted to calculate the viscosity of oilfrom the given composition, pressure and temperature for 20 samples. The tunedequation of state is used to generate oil viscosity values for a range of temperatu
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Titanium alloy (Ti-6Al-4V) samples were nitrided in low pressure (1.3, 3 mbar) dc-glow discharge plasmas of nitrogen. The treating time was 5, 10 and 15 hour and the temperatures range of the samples during the nitriding process was close to 800oC. The obtained microstructures of the nitride layers were studied by x-ray diffraction and optical microscopy. The ε –Ti2N, ζ-Ti3N3-x and η-Ti3N2-x.phases were formed and addition to the solid solution of nitrogen in titanium, α (Ti,N). Micro hardness measurements exhibit an increment for the Ti-alloy specimens which nitrided at 800oC for 10 and 15h.Corrosion measurements were obtained for the Ti-6Al-4V alloy in Ringer solution after plasma nitriding. The clear improving in the corrosion r
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