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
The stratigraphic sequence of Cenomanian-Early Turonian is composed of Ahmadi, Rumaila, and Mishrif formations in the Rifai, Noor and Halfaya Oil Fields within the Mesopotamian Zone of Iraq, which is bounded at top and bottom by unconformity surfaces. The microfacies analysis of the study wells assisted the recognition of five main environments (open marine, basinal, shallow open marine, Rudist biostrome, and lagoon); these microfacies were indicative of a normal lateral change facies from shallow water facies to deeper water and open marine sediments.
Ahmadi Formation (Early Cenomanian) is characterized by open marine sediments during the transgressive conditions, and would be
... Show MoreThe present paper aims at finding out the Variance Ratio of Trips Set Out by Scholars of Both Marrouzzeen and Baihaq .The researcher has come up with conclusion including certain findings ,one of which is that the trip is considered an essential base with high effectiveness since the old times and has been evolved .This means that the trip has been the main source of knowledge and sciences from the scholars directly .This had driven the scholars of both Baihaq and Marrouz cities .It has been noticed , though this paper, that the number of the Marrouz scholars who visited was less than those of Baihaq . The researcher has focused on their meetings or conferences and investigated what has been going on in suc
... Show MoreThe research aims to identify the positives formulation entrances authors depending on the setting retaining the names of the authors of Arab veterans and cons of setting the entrances to Arab authors ancient depending on the nickname by desktop diligence without reference to a setting retaining the potential to benefit other libraries disciple of retaining existing in sober university libraries. Use the survey method and adopted a questionnaire distributed to the research sample consisting of employees working in the libraries in question and the total number of forms that have been distributed (50) form .tousel search phrase conclusions from them .
1-The lack of authority control depends on it to find a
... Show MoreDiyala Governorate has many unique and diverse geomorphological features that the region enjoys, which are among the attractions for natural tourism, as the natural environment is considered a maker of tourism. The importance of geomorphological aspects as components of natural tourism is due to their association with tourism and entertainment, as a result of the enjoyment of many geomorphological aspects of the beauty of its natural landscape on the one hand, and on the other hand, the association of these manifestations with different types of tourism activity. Any tourist area as it is the main factor for tourist attractions, such as the presence of the Hamrin hills, and sand dunes. Planning for the development of tourism activity in the
... Show MoreEmotional exhaustion considered one of the critical factors in the formation and composition of organizational behavior of individuals within organizations, as well as social behavior and psychological, and emotional exhaustion is one of the three components of burnout, as well as depersonalization (cynicism) and low achievement, the emergence of research relevant to this concept began at the beginning of the seventies of the twentieth century, then started to become clear features in the eighties it. This research aims to build intellectual framework for draining emotional exhaustion through highlight on most important philosophical contents, as well as review and analysis of some models associated with this concept, and then a
... Show MoreAbstract
The logistic regression model is one of the nonlinear models that aims at obtaining highly efficient capabilities, It also the researcher an idea of the effect of the explanatory variable on the binary response variable. &nb
... Show MoreThe research aims to identify the concept of green taxes and their role in reducing environmental pollution through the poll of Abnh of taxpayers and employees of the General Authority for taxes totaling 200 individual .autam adoption of the resolution as a tool head for the collection of data and information from the sample and analyzed their responses using a statistical program (spss - 10), and calculating the percentages and the arithmetic mean, standard deviation and research found to a number of conclusions, notably the lack of legislation with the challenges and the difficulty of the existence of a measure or a standard lack of planning for the application of environmental taxes that the state taxation application between the Gene
... Show MoreTo achieve excellence in the quality of performance in school sports administration, which has suffered a lot of problems and constraints on the administrative system, supervision and education level as well as the regulatory environment and available resources available and contribute to the provision of some processors and overcome difficulties to participate in the formation of the individual good of itself and society through sports activities. Hence the importance came this study to create a reference to the quality of the performance criteria school sports from the perspective of supervisors (specialists and technicians) in the districts of breeding Baghdad, to be of help to all those involved in school sports and maintaining an excep
... Show MoreThe aim of the present study is to provide the adequate knowledge about the role of time management in facilitate the work requirements for employees of the administrative department at the Ministry of Higher Education and Scientific Research. The research depend on studying four important dimensions which are (time planning, time organization, time direction and time observation). In addition to study other five dimensions which are (new procedures, clear procedures, short procedures, the available information and the simplicity of the methods
used).Questionnaire sheets consist of (38 questions) distributed to (170) employees and (146) sheets only were considered in the study. SPSS program was used
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