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
Performance evaluation is of great importance in all countries of the world, because it has a prominent and effective role in determining the efficiency and effectiveness of the optimal use of available resources, which are rare and important in achieving the desired objectives. With the continued growth of public spending and the limited resources, the State seeks to achieve its objectives through its units with minimal expenditure or deficit, rationality and wastefulness in the spending. In many countries, particularly developing countries, reforms are made in the public sector to achieve that goal through the adoption of IPSAS, which is reflected in the developmen
... Show MoreIndustrial product is one of the things of daily use and direct interaction with the user, so the ranges of its association to the user, took a varied and multiple aspects. The user today sees the products as things have specifications related directly to the psychology of the user, so he can reflects his values, principles and ideas on the composition of the total structure of the product, making them a means by which manifested the internal entity's of the user took an external materiality. And then counting the products being things excite positive feelings among different user was a natural result given the complexity of the relationship between the user and the industrial product. So pleasure is one important effects that result fro
... Show MoreContemporary arts have achieved, in accordance with the transition of concepts, a new logic in presentation and expression in general, and specifically in the field of ceramic art. The shift towards the logic of rejection and subversion of prevailing methods, which have been almost a constant foundation for a long period, has directly influenced the direction of visual arts in the contemporary world.
The growth and cultural transformations that the world has witnessed after the two World Wars have produced cognitive shifts based on strategies that diverge from the dominant culture. These approaches vary according to existential needs, as the language of art has become conceptual and a medium for contemporary culture with its rapid an
The current research seeks to identify the role of the marketing intelligence system in its dimensions (customer intelligence, market intelligence, competitor intelligence, insurance product intelligence, sales representatives) and its reflection on improving the quality of the insurance service provided by the National Insurance Company represented in its dimensions (reliability, response, tangibility, Safety, the spirit of empathy, communication) adopted in the current research, and based on that, the research came as an attempt to find out the extent to which the research sample company can apply the approach of the marketing intelligence system and its impact on improving the quality of the insurance service provided to custo
... Show MoreThe aim of the research is to determine the impact of profit management practices on the quality of profits through the use of flexibility in determining accounting methods and practices profit information is one of the most important information that concerns current users in general and observing users in particular. Some corporations managements manipulate the results of the company's profit or loss (income statement) and financial position statement with multiple reasons, including capital market motivations to raise their share prices in the stock market and attract investors, and on the other hand the motives of funding and borrowing loans, and the use of the flexibility in accounting policies and estimates to change the in
... Show MoreThis study aims to know the role of strategic leadership to achieving competitiveness in industrial establishments by identifying the respondents’ perceptions about the level of availability of dimensions of leadership strategies (creativity and innovation, risk tolerance, available opportunities) in Bashir Al-Siksek & Partners Company for the manufacture of sanitary and plastic ware in Gaza strip
To achieve this, a questionnaire was developed and distributed to a sample of managers, auditors, accountants, and administrative employees in the study sample company. The questionnaire tool was distributed to 60 employees and employees, of which (52) were retrieved, or 86.6%, and (8) were excluded for la
... Show MoreIn this work, the synergistic effect of chlorinated rubber (additive I),with zeolite 3A (additive II), zeolite 4A (additive III), and zeolite 5A (additive IV) in (1:1) weight percentage, on the flammability for unsaturated polyester resin was studied in the weight ratios for (3,7,10,13&15%) by preparing films of (130×130×3) mm in diameters. Three standard test methods used to measure were the flame retardation which are; ASTM: D-2863, ASTM: D- 635& ASTM: D-3014. Results obtained from these tests indicated that all of the additives were effective additive IV has the highest efficiency as a flame retardant.
The important factor in the success of construction projects is its ability to objective estimate of the cost of the project and adapt to the changes of the external environment, which is affected by a lot of elements and the requirements of the competitive environment. The faces of those projects are several problems in order to achieve particular goals. To overcome these difficulties has been the development of research in the last two decades and turn the focus on the role of the cost of project management, by providing information and assist management in planning and control of the budget among the main elements of the project, namely, (time-cost-quality),The research aims at the possibility of developing and implementing mechanisms
... Show MoreReceipt Date:10/11/2021 Acceptance Date:29/12/2021 Publication Date:31/12/2021
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The study aimed to clarify the conceptual explanations and the theoretical rooting of the concept of the populist phenomenon. And explore the political and cultural implications and connotations contained in populist political discourse. And to stand on the foundations and meanings on w
... Show MoreThe search (floors and transparent role in the design studios satellite channels) and presented as a study-oriented, and the research aims to identify the role of flooring transparent spaces studios satellite channels and side performative and aesthetic, and formulas design to highlight the role floors transparent spaces studios satellite channels. And highlight the importance of research, particularly in its contribution to the clarification of the concept of the relationship between transparency and performing aesthetic treatments for floors by clarifying its role in the designs of the internal spaces of the studios, as well as his contribution to the founding of the theory of looking at the base of such concepts. To achieve the object
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