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
Abstract
The study aims to identify the extent to which the applied colleges at the University of Technology and Applied Sciences meet the comprehensive quality standards in light of the national education strategy for the 2040 Vision in the Sultanate of Oman. To do this, the researchers used the descriptive approach. They used a questionnaire as a tool for data collection that was applied to (237) administrators, academics, and support functions. The study found that the extent to which the applied colleges at the University of Technology and Applied Sciences meet the comprehensive quality standards in the light of the National Education Strategy 2040 in the Sultanate of Oman recorded a high range. The study als
... Show MoreThe heritage of the human peoples remains a beacon of data, after renewed awareness of them, open to their propositions, which are born from the womb of intertwined elements of customs, knowledge, arts, and literature ... Misleading the reception process, it may be something intriguing to identify with caution with the text sample selected by the current search procedures prepared according to the adoption of a descriptive therapist in a three-dimensional approach, as well as a comprehensive textual reference for that specific communication dimension within Anthology Andalusian - Moroccan poetry in the book of pleasure in the perception of the five senses Tahdib ibn Manzoor (d. 711 e) from the origin of Tivashi (d. 651 e) Tagged: Separat
... Show MoreTechnology is an important factor for achieving architecture as an impact and vulnerability. It represents one of the significant elements in creating the intellectual framework, as well as having its own intellectual breakdown, while values constitute the most important and obviously factor of the community's intellectual. Research aims was determined accordingly by: investigating the role and impact of values and their relationship to technology in architecture.
In this context, the research investigated values and technology in architecture, through discussing their aspects and dimensions in architecture. In the context of values, the research discussed their concept and the related ones to have a concrete def
... Show MoreProvides the style of benchmarking the best possible use whenevaluating the performance and evaluation, as well as improved performance,due to its consistency with the principles of good evaluation of theperformance, an extension of the completion of several functions of the timeand cost less, thereby increasing the efficiency of the management of theinstitutions, especially institutions, the media, as it became public the future ofthe message sender to the same time Zaorosaúl new media is challenging thetraditional media of what distinguishes this new interactive media and mass ledto this transition . However, the media Aljdidhoosaúl traditional mediacontinue to coexist and reinforce each Menhmaalakhr, for his wealth offreedom of opin
... Show MoreAjloun Governorate is considered the smallest governorate in Jordan in terms of area, and its population density rises to 472.2 people/ km2 and is distributed among five municipalities. The Al-Shafa municipality is one of these municipalities. Al-Shafa is rich in its natural and human resources, and the first municipal council was established in it in 2001.
This study seeks to achieve the following general objective: inventory the natural and human resources that Al-Shafa enjoys, and highlight the role of Al-Shafa municipality in achieving and settling sustainable development for the local community. Certain content, which are: the comprehensive approach to geographical reality, the descriptive
... Show MoreThis research aims to underscore the significance of women's emotional intelligence in enhancing the effectiveness of the Board of Directors, a crucial component of internal governance, particularly during crises. Despite strides made in recent decades in appointing women to senior roles in government, business, and education, challenges persist in improving women's leadership opportunities, especially in developing countries. The study utilizes statistical methods, including Pearson's correlation, to analyze the relationships between variables within a sample of banks listed on the Iraqi securities market, comparing periods before and during the COVID-19 pandemic (2019 and 2020). The goal is to measure the impact of female emotiona
... Show MoreThe current research aims to reveal the reality of coping the scientific research in Omani universities in the Sultanate of Oman with the requirements of the Fourth Industrial Revolution in the light of Oman’s 2040 vision. It also aims derive some suggestions to develop the scientific research in these institutions. The study has adopted a qualitative approach in which interviews were conducted. The sample consisted of (16) leaders of governmental and private higher education institutions, as well as, some experts in the field of Fourth Industrial Revolution. The theoretical significance of the study is represented by its response to Oman’s vison in 2040. It is further in line with the previous international reports and educational s
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